U.S. patent application number 15/383220 was filed with the patent office on 2017-04-06 for energy treatment unit, energy treatment instrument and energy treatment system.
This patent application is currently assigned to OLYMPUS CORPORATION. The applicant listed for this patent is OLYMPUS CORPORATION. Invention is credited to Mizuki KOMIYA, Kazunori TANIGUCHI.
Application Number | 20170095262 15/383220 |
Document ID | / |
Family ID | 54935256 |
Filed Date | 2017-04-06 |
United States Patent
Application |
20170095262 |
Kind Code |
A1 |
KOMIYA; Mizuki ; et
al. |
April 6, 2017 |
ENERGY TREATMENT UNIT, ENERGY TREATMENT INSTRUMENT AND ENERGY
TREATMENT SYSTEM
Abstract
A liquid feed conduit and a suction conduit extends in a hollow
portion from a probe proximal portion direction to a probe distal
portion direction in an inside of a probe, and an ejection port of
the liquid feed conduit and a suction port of the suction conduit
are located in the hollow portion. A collision surface is provided
in the probe to be opposed to at least a part of the ejection port,
and the collision surface is located on the probe distal portion
direction side with respect to the suction port and the ejection
port. At least part of a liquid ejected from the ejection port
collides with the collision surface in the hollow portion.
Inventors: |
KOMIYA; Mizuki;
(Hachioji-shi, JP) ; TANIGUCHI; Kazunori;
(Hamburg, DE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
OLYMPUS CORPORATION |
Tokyo |
|
JP |
|
|
Assignee: |
OLYMPUS CORPORATION
Tokyo
JP
|
Family ID: |
54935256 |
Appl. No.: |
15/383220 |
Filed: |
December 19, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
PCT/JP2015/062864 |
Apr 28, 2015 |
|
|
|
15383220 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/22004 20130101;
A61B 17/2202 20130101; A61B 2018/00994 20130101; A61B 18/1445
20130101; A61B 2217/007 20130101; A61B 18/12 20130101; A61B
2218/002 20130101; A61B 18/00 20130101; A61B 17/320092 20130101;
A61B 2217/005 20130101; A61B 2218/007 20130101; A61B 2018/00035
20130101 |
International
Class: |
A61B 17/22 20060101
A61B017/22; A61B 18/12 20060101 A61B018/12; A61B 18/00 20060101
A61B018/00 |
Foreign Application Data
Date |
Code |
Application Number |
Jun 19, 2014 |
JP |
2014-126626 |
Claims
1. An energy treatment unit comprising: a probe including a probe
distal portion and a probe proximal portion, and extending along a
longitudinal axis, a hollow portion being formed in an inside of
the probe along the longitudinal axis, and the probe being
configured to be capable of transmitting energy from the probe
proximal portion toward the probe distal portion; a treatment
section provided in the probe distal portion of the probe, and
having an outer surface on which an opening portion, through which
the hollow portion is open to an outside of the probe, is formed,
the treatment section being configured to perform a treatment by
using the energy which is transmitted through the probe; a suction
conduit extending through the hollow portion from a probe proximal
portion direction to a probe distal portion direction, and
including a distal end at which a suction port located in the
hollow portion is formed, the suction conduit being configured such
that suction force occurs from the suction port toward the probe
proximal portion direction; a liquid feed conduit extending through
the hollow portion from the probe proximal portion direction to the
probe distal portion direction, and including a distal end at which
an ejection port located in the hollow portion is formed, the
liquid feed conduit being configured to eject liquid from the
ejection port toward a probe distal portion direction side; and a
collision surface provided in the probe in such a state as to be
opposed to at least a part of the ejection port, the collision
surface being located on the probe distal portion direction side
with respect to the suction port and the ejection port, and the
collision surface being configured such that at least part of the
liquid ejected from the ejection port collides with the collision
surface in the hollow portion.
2. The energy treatment unit of claim 1, wherein part of the liquid
ejected from the ejection port is ejected to the outside of the
probe from the hollow portion through the opening portion.
3. The energy treatment unit of claim 2, wherein the outer surface
of the treatment section includes a treatment section distal
surface which forms a distal end of the probe, and a treatment
section side surface extending from the treatment section distal
surface toward the probe proximal portion direction, and the
opening portion of the hollow portion is located on the treatment
section side surface or the treatment section distal surface.
4. An energy treatment instrument comprising: the energy treatment
unit of claim 3; a sheath through which the probe is inserted in a
state in which the treatment section projects toward the probe
distal portion direction; and a jaw rotatably attached to the
sheath, and configured to rotate relative to the sheath, thereby
opening or closing relative to the treatment section of the probe,
wherein the treatment section side surface of the treatment section
includes a probe-side counter-surface which is opposed to the jaw,
and which faces toward an opening direction of the jaw, and the
opening portion of the hollow portion is located at a position on
the treatment section side surface of the treatment section, which
is other than the probe-side counter-surface.
5. The energy treatment unit of claim 3, wherein the opening
portion is a plurality of opening portions formed on the treatment
section side surface, in a first opening portion which is one of
the opening portions, a distance from the suction port of the
suction conduit is less than a distance from the ejection port of
the liquid feed conduit, and in a second opening portion which is
another of the opening portions and is different from the first
opening portion, a distance from the ejection port of the liquid
feed conduit is less than a distance from the suction port of the
suction conduit.
6-10. (canceled)
11. The energy treatment unit of claim 1, further comprising a
communication portion configured to establish communication between
the liquid feed conduit and the suction conduit on a probe proximal
portion direction side with respect to the suction port and the
ejection port, wherein at least part of the liquid, which passes
through the liquid feed conduit, does not flow into the suction
conduit from the communication portion, and is supplied to the
ejection port.
12. The energy treatment unit of claim 1, wherein a cross section
of the suction conduit, which is perpendicular to the longitudinal
axis, has a cylindrical shape surrounding an outer peripheral side
of the liquid feed conduit, and the ejection port of the liquid
feed conduit is located on the probe distal portion direction side
with respect to the suction port of the suction conduit, or wherein
a cross section of the liquid feed conduit, which is perpendicular
to the longitudinal axis, has a cylindrical shape surrounding an
outer peripheral side of the suction conduit, and the suction port
of the suction conduit is located on the probe distal portion
direction side with respect to the ejection port of the liquid feed
conduit.
13. (canceled)
14. The energy treatment unit of claim 1, wherein a position of the
ejection port of the liquid feed conduit agrees with a position of
the opening portion of the hollow portion in a longitudinal
direction which is parallel to the longitudinal axis, or is located
on a probe proximal portion direction side with respect to the
opening portion, and a position of the suction port of the suction
conduit agrees with the position of the opening portion in the
longitudinal direction, or is located on the probe proximal portion
direction side with respect to the opening portion.
15. An energy treatment instrument comprising: the energy treatment
unit of claim 1; a sheath through which the probe is inserted in a
state in which the treatment section projects toward the probe
distal portion direction; and a holding unit coupled to a probe
proximal portion direction side of the sheath, and configured such
that the probe extends from an inside of the holding unit toward
the probe distal portion direction through an inside of the
sheath.
16. The energy treatment instrument of claim 15, further comprising
a conduit attachment/detachment portion configured to detachably
couple the liquid feed conduit and the suction conduit to the probe
and the holding unit, by inserting, in the inside of the holding
unit, the liquid feed conduit and the suction conduit from the
probe proximal portion direction side into the hollow portion of
the probe.
17. (canceled)
18. An energy treatment instrument comprising: the energy treatment
unit of claim 1; an external liquid feed conduit extending from the
probe proximal portion direction toward the probe distal portion
direction through the outside of the probe, the external liquid
feed conduit including a distal end at which an external ejection
port located on the outside of the probe is formed and the external
liquid feed conduit being configured to eject supplied liquid from
the external ejection port toward the probe distal portion
direction sick; a sheath through which the probe is inserted in a
state in which the treatment section projects toward the probe
distal portion direction; and a jaw rotatably attached to the
sheath, and configured to rotate relative to the sheath, thereby
opening or closing relative to the treatment section of the probe,
wherein the outer surface of the treatment section includes a
probe-side counter-surface which is opposed to the jaw, and which
faces toward an opening direction of the jaw, the external liquid
feed conduit extends through between the probe and the sheath, and
the external ejection port of the external liquid feed conduit is
located on the probe distal portion direction side with respect to
a distal end of the sheath, and is located on the probe-side
counter-surface.
19. An energy treatment system comprising: the energy treatment
unit of claim 1; and an energy source unit configured to output the
energy which is used for the treatment in the treatment section,
the output energy being transmitted to the treatment section
through the probe.
20. The energy treatment system of claim 19, further comprising a
vibration causing section configured to cause ultrasonic vibration
by being supplied with electric power, wherein the energy source
unit includes an ultrasonic energy source configured to output, as
the energy, electric power which is supplied to the vibration
causing section, the probe is configured to transmit the ultrasonic
vibration, which is caused by the ultrasonic causing section, from
the probe proximal portion direction to the probe distal portion
direction, and the treatment section is configured to perform the
treatment by using the transmitted ultrasonic vibration.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This is a Continuation Application of PCT Application No.
PCT/JP2015/062864, filed Apr. 28, 2015 and based upon and claiming
the benefit of priority from prior Japanese Patent Application No.
2014-126626, filed Jun. 19, 2014, the entire contents of which are
incorporated herein by reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates to an energy treatment unit
configured such that a treatment section, which performs a
treatment by using transmitted energy, is provided in a distal
portion of a probe which can transmit energy, and a suction conduit
extends in a hollow portion in the inside of the probe. In
addition, the invention relates to an energy treatment instrument
and an energy treatment system each including the energy treatment
unit.
[0004] 2. Description of the Related Art
[0005] U.S. Patent Application Publication No. 2007/0162050
discloses a treatment instrument (energy treatment instrument)
including a probe which extends along a longitudinal axis. The
probe transmits ultrasonic vibration from a proximal direction to a
distal direction as energy that is used for a treatment. A
treatment section, which is provided in a distal portion of the
probe, treats a treated target such as a biological tissue, by
using the transmitted ultrasonic vibration. The probe is inserted
through a sheath in the state in which the treatment section
projects toward the distal direction. A space portion is formed
between the probe and sheath, and a liquid, such as physiological
saline, is supplied in the space portion toward the distal
direction side. Specifically, the space portion between the probe
and sheath serves as a liquid feed conduit through which the liquid
is supplied toward the distal direction side. Then, in a state in
which the probe is caused to ultrasonically vibrate, the liquid,
which has been supplied, is ejected from the distal end of the
liquid feed conduit toward the distal direction side, and thereby
cavitation occurs near a distal surface of the probe. A biological
tissue with low resiliency, such as hepatic cells, is crushed and
emulsified. In addition, a hollow portion is formed along the
longitudinal axis in the inside of the probe, and the hollow
portion is open to the outside of the probe at an opening portion
of the distal surface of the probe. The treated target (biological
tissue), which was crushed and emulsified by the cavitation, is
sucked into the hollow portion through the opening portion, and
moves in the hollow portion toward the proximal direction.
Specifically, the hollow portion in the inside of the probe serves
as a suction conduit through which sucked object moves toward the
proximal direction.
BRIEF SUMMARY OF THE INVENTION
[0006] According to one aspect of the invention, an energy
treatment unit includes that: a probe including a probe distal
portion and a probe proximal portion, and extending along a
longitudinal axis, a hollow portion being formed in an inside of
the probe along the longitudinal axis, and the probe being
configured to be capable of transmitting energy from the probe
proximal portion toward the probe distal portion; a treatment
section provided in the probe distal portion of the probe, and
having an outer surface on which an opening portion, through which
the hollow portion is open to an outside of the probe, is formed,
the treatment section being configured to perform a treatment by
using the energy which is transmitted through the probe; a suction
conduit extending through the hollow portion from a probe proximal
portion direction to a probe distal portion direction, and
including a distal end at which a suction port located in the
hollow portion is formed, the suction conduit being configured such
that suction force occurs from the suction port toward the probe
proximal portion direction; a liquid feed conduit extending through
the hollow portion from the probe proximal portion direction to the
probe distal portion direction, and including a distal end at which
an ejection port located in the hollow portion is formed, the
liquid feed conduit being configured to eject liquid from the
ejection port toward a probe distal portion direction side; and a
collision surface provided in the probe in such a state as to be
opposed to at least a part of the ejection port, the collision
surface being located on the probe distal portion direction side
with respect to the suction port and the ejection port, and the
collision surface being configured such that at least part of the
liquid ejected from the ejection port collides with the collision
surface in the hollow portion.
[0007] Advantages of the invention will be set forth in the
description which follows, and in part will be obvious from the
description, or may be learned by practice of the invention. The
advantages of the invention may be realized and obtained by means
of the instrumentalities and combinations particularly pointed out
hereinafter.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING
[0008] The accompanying drawings, which are incorporated in and
constitute a part of the specification, illustrate embodiments of
the invention, and together with the general description given
above and the detailed description of the embodiments given below,
serve to explain the principles of the invention.
[0009] FIG. 1 is a schematic view illustrating the configuration of
an energy treatment system according to a first embodiment;
[0010] FIG. 2 is a cross-sectional view which schematically
illustrates the configuration of a transducer unit according to the
first embodiment;
[0011] FIG. 3 is a cross-sectional view which schematically
illustrates the configuration of a probe and a distal portion of a
horn member according to the first embodiment;
[0012] FIG. 4 is a schematic view illustrating, in partial cross
section, the configuration of a distal portion of an energy
treatment instrument including a treatment section and a jaw
according to the first embodiment;
[0013] FIG. 5 is a cross-sectional view which schematically
illustrates the configuration of a conduit unit according to the
first embodiment;
[0014] FIG. 6 is a cross-sectional view which schematically
illustrates the configuration of a proximal portion of the conduit
unit and the transducer unit according to the first embodiment, in
a state in which the conduit unit is coupled to the probe, a
holding unit and the transducer unit;
[0015] FIG. 7 is a cross-sectional view which schematically
illustrates a configuration in which the conduit unit according to
the first embodiment is detachably coupled to the probe, holding
unit and transducer unit;
[0016] FIG. 8 is a schematic view illustrating the configuration of
a state setting unit 85 according to the first embodiment;
[0017] FIG. 9 is a schematic view illustrating a variation with
time of longitudinal vibration at a certain position of the
treatment section, in a state in which energy is being output in a
fourth output mode from an energy source unit according to the
first embodiment;
[0018] FIG. 10 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a first
modification;
[0019] FIG. 11 is a schematic view of a treatment section distal
surface of the treatment section according to the first
modification, as viewed from the distal direction side;
[0020] FIG. 12 is a schematic view of a treatment section distal
surface of a treatment section according to a second modification,
as viewed from the distal direction side;
[0021] FIG. 13 is a schematic view of a treatment section distal
surface of a treatment section according to a third modification,
as viewed from the distal direction side;
[0022] FIG. 14 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a fourth
modification;
[0023] FIG. 15 is a schematic view illustrating, in partial cross
section, the configuration of a distal portion of an energy
treatment instrument including a treatment section and a jaw
according to a fifth modification;
[0024] FIG. 16 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a sixth
modification;
[0025] FIG. 17 is a cross-sectional view which schematically
illustrates a cross section passing through an opening portion of
the treatment section according to the sixth modification, and
being perpendicular to the longitudinal axis;
[0026] FIG. 18 is a cross-sectional view which schematically
illustrates a cross section passing through an opening portion of a
treatment section according to a seventh modification, and being
perpendicular to the longitudinal axis;
[0027] FIG. 19 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to an eighth
modification;
[0028] FIG. 20 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a ninth
modification;
[0029] FIG. 21 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a tenth
modification;
[0030] FIG. 22 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to an eleventh
modification;
[0031] FIG. 23 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a twelfth
modification;
[0032] FIG. 24 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a 13th
modification;
[0033] FIG. 25 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a 14th
modification;
[0034] FIG. 26 is a cross-sectional view which schematically
illustrates the configuration of a treatment section of a probe and
a distal portion of a conduit unit according to a 15th
modification;
[0035] FIG. 27 is a schematic view illustrating, in partial cross
section, the configuration of a distal portion of an energy
treatment instrument including a treatment section and a jaw
according to a 16th modification;
[0036] FIG. 28 is a schematic view illustrating, in partial cross
section, the configuration of a distal portion of an energy
treatment instrument including a treatment section and a jaw
according to a 17th modification;
[0037] FIG. 29 is a schematic view illustrating an example of
variations with time of the presence/absence of an input of an
energy operation in an energy operation input section, an actuation
state of a liquid feed actuation section, and an actuation state of
a suction actuation section according to a 18th modification;
[0038] FIG. 30 is a schematic view illustrating the configuration
of a probe and a probe holder, to which the probe is fixed,
according to a reference example;
[0039] FIG. 31 is a cross-sectional view which schematically
illustrates a cross section perpendicular to a longitudinal axis of
a treatment section according to the reference example; and
[0040] FIG. 32 is a cross-sectional view which schematically
illustrates a cross section perpendicular to a longitudinal axis
passing through a flange portion of the probe and the probe holder
according to the reference example.
DETAILED DESCRIPTION OF THE INVENTION
First Embodiment
[0041] A first embodiment of the present invention will be
described with reference to FIG. 1 to FIG. 9.
[0042] FIG. 1 is a view illustrating the configuration of an energy
treatment system 1 of the present embodiment. As illustrated in
FIG. 1, the energy treatment system 1 includes an energy treatment
instrument (handpiece) 2. The energy treatment instrument 2 has a
longitudinal axis C. Here, a direction parallel to the longitudinal
axis C is set as a longitudinal direction. One side in the
longitudinal direction is a distal direction (a direction of arrow
C1 in FIG. 1), and the side opposite to the distal direction is a
proximal direction (a direction of arrow C2 in FIG. 1). In this
embodiment, the energy treatment instrument 2 is an ultrasonic
treatment instrument which treats a treated target, such as a
biological tissue, by using ultrasonic vibration as energy, and is
also a high-frequency treatment instrument which treats the treated
target by using high-frequency electric power (high-frequency
current) as energy.
[0043] The energy treatment instrument 2 includes a holding unit
(handle unit) 3. The holding unit 3 includes a cylindrical case
portion 5 which extends along the longitudinal axis C, and a
stationary handle 6 which extends from the cylindrical case portion
5 in a certain direction crossing the longitudinal axis C. The
cylindrical case portion 5 and stationary handle 6 are formed as
one piece. A movable handle 7 is rotatably attached to the
cylindrical case portion 5. By the movable handle 7 rotating about
the position of attachment to the cylindrical case portion 5, the
movable handle 7 opens or closes relative to the stationary handle
6. In the present embodiment, the movable handle 7 is located on
the distal direction side with respect to the stationary handle 6.
In addition, the holding unit 3 includes a rotary operation knob 8
which is a rotary operation input section that is attached to a
distal direction side of the cylindrical case portion 5. The rotary
operation knob 8 is rotatable about the longitudinal axis C
relative to the cylindrical case portion 5.
[0044] In addition, energy operation input buttons 9A to 9C, which
are energy operation input sections, are attached to the
cylindrical case portion 5 of the holding unit 3. The energy
operation input buttons 9A and 9B are located on the side where the
stationary handle 6 is located, with reference to the longitudinal
axis C as the center.
[0045] Besides, in this embodiment, the energy operation input
buttons 9A and 9B are located on the distal direction side with
respect to the stationary handle 6. The energy operation input
button 9C is located on the side opposite to the side where the
stationary handle 6 is located, with reference to the longitudinal
axis C as the center. The energy operation input buttons 9A to 9C
are detachably attached to the cylindrical case portion 5.
[0046] The energy treatment instrument 2 includes a transducer unit
11. The transducer unit 11 includes a transducer case 12. The
transducer case 12 is rotatable about the longitudinal axis C
relative to the cylindrical case portion 5 with the rotary
operation knob 8. The transducer case 12 is attached to the holding
unit 3, by the transducer case 12 being inserted into the inside of
the cylindrical case portion 5 from the proximal direction side.
One end of a cable 13 is connected to the oscillator case 12. The
energy treatment system 1 includes an energy source unit 15 which
is, for example, an energy control device. The other end of the
cable 13 is connected to the energy source unit 15. In the present
embodiment, the energy source unit 15 includes an ultrasonic energy
source 16, a high-frequency energy source 17, and a controller 18.
Each of the ultrasonic energy source 16 and high-frequency energy
source 17 is composed of, for example, power supply and converter
circuit. The controller 18 is composed of a processor which
includes, for example, a CPU (Central Processing Unit) or an ASIC
(Application Specific Integrated Circuit). In addition, the energy
source unit 15 is electrically connected to an energy operation
input switch 10 such as a footswitch, which is an energy operation
input section. The energy operation input switch 10 is provided as
a separated body from the energy treatment instrument 2.
[0047] FIG. 2 is a view illustrating the configuration of the
transducer unit 11. As illustrated in FIG. 2, the transducer unit
11 includes an ultrasonic transducer 21 which is a vibration
causing section that is provided in the inside of the transducer
case 12. The ultrasonic transducer 21 includes a plurality (six in
this embodiment) of piezoelectric elements 22 which convert an
electric current (AC current) to ultrasonic vibration. One end of
each of electric path portions 23A and 23B is connected to the
ultrasonic oscillator 21. The electric path portions 23A and 23B
extend through the inside of the cable 13, and the other ends of
the electric path portions 23A and 23B are connected to the
ultrasonic energy source 16 of the energy source unit 15. The
electric path portions 23A and 23B are formed of electric wiring
lines which extend in the inside of the transducer case 12, and
electric wiring lines which extend in the inside of the cable 13.
Ultrasonic electric power (ultrasonic energy) is supplied from the
ultrasonic energy source 16 to the ultrasonic transducer 21 via the
electric path portions 23A and 23B, and thereby ultrasonic
vibration is caused by the ultrasonic transducer 21. Specifically,
the ultrasonic energy source 16 outputs ultrasonic electric power
which is energy that is supplied to the ultrasonic transducer 21.
Then, by the supply of the ultrasonic electric power (AC current),
ultrasonic vibration is caused by the ultrasonic transducer 21 as
energy that is used for a treatment.
[0048] The ultrasonic transducer 21 is attached to a cylindrical
elements-attached member 25. The ultrasonic transducer 21, which
includes the piezoelectric elements 22, is fixed to an outer
peripheral surface of the elements-attached member 25. A
cylindrical horn member 26 is connected to a distal direction side
of the elements-attached member 25. The horn member 26 is
continuous with a distal direction side of the ultrasonic
transducer 21. The horn member 26 includes a cross-sectional area
varying portion 27 having a cross-sectional area perpendicular to
the longitudinal axis C, which gradually decreases toward the
distal direction. The ultrasonic vibration, which is caused by the
ultrasonic transducer 21, is transmitted to the horn member 26, and
is transmitted in the horn member 26 from the proximal direction to
the distal direction. The amplitude of the ultrasonic vibration,
which is transmitted to the horn member 26, is increased in the
cross-sectional area varying portion 27. In addition, since the
horn member 26 and elements-attached member 25 are formed in
cylindrical shapes, a cavity portion 28 is formed in the inside of
the horn member 26 and in the inside of the elements-attached
member 25. The cavity portion 28 extends along the longitudinal
axis C from a proximal end of the elements-attached member 25 to a
distal end of the horn member 26.
[0049] As illustrated in FIG. 2, the transducer case 12 is provided
with a case proximal wall 31 which forms a proximal end of the
transducer case 12, and a cylindrical connection member 32 is fixed
to the case proximal wall 31. The connection member 32 projects
from the case proximal wall 31 toward the distal direction in the
inside of the transducer case 12. The connection member 32 is
coupled to the elements-attached member 25 from the proximal
direction side via a cylindrical vibration damping member 33. In
addition, the vibration damping member 33 is clamped between the
connection member 32 and a removal prevention member 35 in the
longitudinal direction that is parallel to the longitudinal axis C,
and the movement of the vibration damping member 33 in the
longitudinal direction relative to the connection member 32 and
elements-attached member 25 is restricted.
[0050] Since the connection member 32 and vibration damping member
33 are formed in cylindrical shapes, a space portion 36 is formed
in the inside of the connection member 32 and in the inside of the
vibration damping member 33. The space portion 36 extends along the
longitudinal axis C from a proximal end of the connection member 32
to a distal end of the vibration damping member 33. A distal end of
the space portion 36 communicates with a proximal end of the cavity
portion 28 which extends in the inside of the elements-attached
member 25. In addition, a proximal end of the space portion 36 is
open to the outside of the transducer unit 11 (the outside of the
transducer case 12).
[0051] As illustrated in FIG. 1, the energy treatment instrument 2
includes a sheath 40 which extends along the longitudinal axis C.
The sheath 40 is attached to the holding unit 3, by the sheath 40
being inserted into the inside of the rotary operation knob 8 and
the inside of the cylindrical case portion 5 from the distal
direction side. Specifically, the holding unit 3 is coupled to a
proximal direction side of the sheath 40. In the inside of the
cylindrical case portion 5, the sheath 40 is attached to a distal
direction side of the transducer case 12. In addition, the energy
treatment instrument 2 includes a probe (ultrasonic probe) 41 which
is inserted through the sheath 40. The probe 41 extends along the
longitudinal axis C toward the distal direction from the inside of
the holding unit 3 (the inside of the cylindrical case portion 5)
through the inside of the sheath 40. In this embodiment, the
longitudinal axis C agrees with the center axis of the probe 41.
The probe 41 includes a probe distal portion and a probe proximal
portion, and extends along the longitudinal axis C from the probe
proximal portion toward the probe distal portion. The probe distal
portion of the probe 41 is provided with a treatment section 42.
Here, a direction toward the probe distal portion in the probe 41
is defined as a probe distal portion direction, and a direction
toward the probe proximal portion in the probe 41 is defined as a
probe proximal portion direction. In the present embodiment, the
probe distal portion direction agrees with the above-described
distal direction, and the probe proximal portion direction agrees
with the above-described proximal direction. The treatment section
42 projects from a distal end of the sheath 40 toward the probe
distal portion direction.
[0052] In addition, a jaw 43 is rotatably attached to a distal
portion of the sheath 40. By opening or closing the movable handle
7 relative to the stationary handle 6, a movable portion (not
shown) provided in the sheath 40 moves along the longitudinal axis
C. Thereby, the jaw 43 rotates, and the jaw 43 opens or closes
relative to the treatment section 42 of the probe 41. The sheath
40, probe 41 and jaw 43 can rotate with the rotary operation knob 8
about the longitudinal axis C relative to the cylindrical case
portion 5.
[0053] FIG. 3 is a view illustrating the configuration of the probe
41 and a distal portion of the horn member 26. As illustrated in
FIG. 3, the probe 41 extends along the longitudinal axis C. A
female screw portion 45A is formed in the distal portion of the
horn member 26, and a male screw portion 45B is formed in a
proximal portion of the probe 41. By the male screw portion 45B
being engaged with the female screw portion 45A, the probe 41 is
connected to the distal direction side of the horn member 26. The
probe 41 is connected to the horn member 26 in the inside of the
cylindrical case portion 5 of the holding unit 3.
[0054] A hollow portion 46 is formed along the longitudinal axis C
in the inside of the probe 41. The hollow portion 46 extends from
the probe proximal portion of the probe 41 to the probe distal
portion (treatment section 42) of the probe 41. The hollow portion
46 is open to the outside of the probe 41 at an opening portion 47
which is located on an outer surface of the treatment section 42.
The opening portion 47 establishes communication between the hollow
portion 46 in the inside of the probe 41 and the outside of the
probe 41. In the state in which the probe 41 is connected to the
horn member 26, a proximal end of the hollow portion 46
communicates with a distal end of the cavity portion 28 which
extends in the inside of the horn member 26. Accordingly, in the
state in which the probe 41 is connected to the horn member 26, the
opening portion 47 of the hollow portion 46 communicates with the
proximal end of the space portion 36 via the hollow portion 46,
cavity portion 28 and space portion 36.
[0055] Vibration, which has been transmitted from the ultrasonic
transducer 21 to the horn member 26, is transmitted to the
ultrasonic probe 41. Further, the probe 41, which is the ultrasonic
probe, transmits ultrasonic vibration, which is energy, from the
probe proximal portion direction to the probe distal portion
direction. In addition, the treatment section 42 performs treatment
by using the transmitted ultrasonic vibration. At this time, a
vibrating body unit 20, which transmits ultrasonic vibration caused
by the ultrasonic transducer 21 and vibrates by the ultrasonic
vibration, is constituted by the elements-attached member 25, horn
member 26 and probe 41. In the meantime, the amplitude of vibration
by ultrasonic vibration does not large in the elements-attached
member 25 which is located on the proximal side with respect to the
cross-sectional area varying portion 27 of the horn member 26. In
addition, the ultrasonic vibration, which is transmitted from the
elements-attached member 25 to the probe proximal portion
direction, is damped by the vibration damping member 33. Thus, the
ultrasonic vibration is not transmitted from the elements-attached
member 25 (vibrating body unit 20) to the connection member 32 and
transducer case 12, and the connection member 32 and transducer
case 12 do not vibrate by the ultrasonic vibration.
[0056] The vibrating body unit 20 vibrates in a preset vibration
mode (vibration state) which is used at a time of treatment, by
transmitting the ultrasonic vibration caused by the ultrasonic
transducer 21. In the preset vibration mode, the vibrating body
unit 20 performs longitudinal vibration, the vibration direction of
which is parallel to the longitudinal axis C (longitudinal
direction). In addition, in the preset vibration mode, a distal end
of the vibrating body unit 20 (a distal end of the probe 41) and a
proximal end of the vibrating body unit 20 (the proximal end of the
elements-attached member 25) are at antinode positions of the
longitudinal vibration. Here, an antinode position Al, which is
located at the distal end of the vibrating body unit 20, is located
most on the probe distal portion direction side among the antinode
positions of longitudinal vibration, and an antinode position A2,
which is located at the proximal end of the vibrating body unit 20,
is located most on the probe proximal portion direction side among
the antinode positions of longitudinal vibration. In addition, in
the established vibration mode, the number of antinode positions of
longitudinal vibration and the number of node positions of
longitudinal vibration between the distal end of the vibrating body
unit 20 and the proximal end of the vibrating body unit 20 are
fixed, and at least one node position of longitudinal vibration
exists between the distal end of the vibrating body unit 20 and the
proximal end of the vibrating body unit 20. The controller 18
adjusts the frequency of an electric current (AC current) which is
supplied from the ultrasonic energy source 16 to the ultrasonic
transducer 21, thereby adjusting the resonance frequency of the
vibrating body unit 20 and causing the vibrating body unit 20 to
vibrate in the preset vibration mode. In the meantime, the preset
vibration mode (i.e. the number of node positions and antinode
positions of longitudinal vibration) is determined in accordance
with the dimension in the longitudinal direction of the used
vibrating body unit 20, the kind of treatment, etc.
[0057] In addition, the elements-attached member 25 is electrically
connected to the high-frequency energy source 17 of the energy
source unit 15 via an electric path portion (not shown). The
electric path portion is formed of an electric wiring line which
extends in the inside of the transducer case 12, and an electric
wiring line which extends in the inside of the cable 13. The
high-frequency energy source 17 outputs high-frequency electric
power (high-frequency energy) as energy that is used for a
treatment. The high-frequency electric power, which is output from
the high-frequency energy source 17, is supplied to the treatment
section 42 through the electric path portion (not shown),
elements-attached member 25, horn member 26 and probe 41.
Specifically, a probe-side electricity supply path P1 of
high-frequency electric power, which is output from the
high-frequency energy source 17, is formed by the electric path
portion (not shown), elements-attached member 25, horn member 26
and probe 41. The treatment section 42 functions as an electrode,
by the high-frequency electric power being supplied (transmitted)
to the treatment section 42 via the probe-side electricity supply
path P1.
[0058] In addition, the transducer case 12 is provided with an
electric conductor portion (not shown). The electric conductor
portion of the transducer case 12 is electrically connected to an
electric conductor portion (not shown) of the jaw 43 via an
electric conductor portion (not shown) of the sheath 40. Besides,
the electric conductor portion of the transducer case 12 is
electrically connected to the high-frequency energy source 17 of
the energy source unit 15 via an electric path portion (not shown).
The electric path portion is formed of a part that is different
from a part which forms the probe-side electricity supply path P1,
and is formed of an electric wiring line which extends in the
inside of the transducer case 12, and an electric wiring line which
extends in the inside of the cable 13. The high-frequency electric
power, which is output from the high-frequency energy source 17, is
supplied to the electric conductor portion of the jaw 43 through
the electric path portion (not shown), the electric conductor
portion of the transducer case 12 and the electric conductor
portion of the sheath 40. Specifically, a jaw-side electricity
supply path P2 of high-frequency electric power, which is output
from the high-frequency energy source 17, is formed by the electric
path portion (not shown), the electric conductor portion of the
transducer case 12 and the electric conductor portion of the sheath
40. The electric conductor portion of the jaw 3 functions as an
electrode which is different in electric potential from the
treatment section 42, by the high-frequency electric power being
supplied (transmitted) to the electric conductor portion of the jaw
3 via the jaw-side electricity supply path P2.
[0059] In the meantime, the probe 41 is supported by the sheath 40
via a support member (not shown) which is formed of an electrically
insulating material, and the horn member 26 is supported by the
transducer case 12 via a support member (not shown) which is formed
of an electrically insulating material. Thus, the probe 41 is
prevented from coming in contact with the sheath 40, and the horn
member 26 is prevented from coming in contact with the oscillator
case 12. Accordingly, short-circuit between the probe-side
electricity supply path P1 and jaw-side electricity supply path P2
is prevented. In addition, in the state in which the transducer
unit 20 vibrates in the preset vibration mode, each of the
above-described support members is located at a node position of
longitudinal vibration, and the support member is formed of a
material which has a low vibration transmissibility and damps
vibration. Thus, no ultrasonic vibration is transmitted from the
probe 41 and horn member 26 (vibrating body unit 20) to the sheath
40 and transducer case 12, and the sheath 40 and transducer case 12
do not vibrate due to ultrasonic vibration.
[0060] FIG. 4 is a view illustrating the configuration of the
distal portion of the energy treatment instrument 2 including the
treatment section 42 and jaw 43. As illustrated in FIG. 4, a liquid
feed tube 51 and a suction tube 52 extend from the probe proximal
portion direction to the probe distal portion direction in the
hollow portion 46 in the inside of the probe 41. A conduit unit 50
including the liquid feed tube 51 and suction tube 52 is detachably
coupled to the probe 41, holding unit 3 and transducer unit 11. In
addition, an energy treatment unit 30, which performs treatment by
the treatment section 42 with use of energy, is composed of the
probe 41 and conduit unit 50.
[0061] FIG. 5 is a view illustrating the configuration of the
conduit unit 50. As illustrated in FIG. 4 and FIG. 5, in the
conduit unit 50 of this embodiment, the suction tube 52 is inserted
through the inside of the liquid feed tube 51. In the inside of the
suction tube 52, a suction conduit 55 extends from the probe
proximal portion direction to the probe distal portion direction.
In the present embodiment, a conduit axis (suction conduit axis)
S2, which is the center axis of the suction conduit 55, is coaxial
with the longitudinal axis C. In addition, in the conduit unit 50,
a liquid feed conduit 53 extends from the probe proximal portion
direction to the probe distal portion direction between the inner
peripheral surface of the liquid feed tube 51 and the outer
peripheral surface of the suction tube 52. In this embodiment, a
conduit axis (liquid feed conduit axis) S1, which is the center
axis of the liquid feed conduit 53, is coaxial with the
longitudinal axis C. As described above, by the conduit unit 50
being coupled to the holding unit 3 and transducer unit 11, the
liquid feed conduit 53 and suction conduit 55 extend from the probe
proximal portion direction to the probe distal portion direction in
the hollow portion 46 of the probe 41. In addition, in this
embodiment, the cross section of the suction conduit 55, which is
perpendicular to the longitudinal axis C, has a circular shape
about the longitudinal axis C (conduit axis S2), and the cross
section of the liquid feed conduit 53, which is perpendicular to
the longitudinal axis C, has a cylindrical (circular cylindrical)
shape surrounding the outer peripheral side of the suction conduit
55.
[0062] An ejection port 56 is formed at a distal end of the liquid
feed conduit 53. In addition, a suction port 57 is formed at a
distal end of the suction conduit 55. The ejection port 56 and
suction port 57 are located in a distal portion of the hollow
portion 46 which is formed in the inside of the probe 41.
Specifically, the liquid feed conduit 53 and suction conduit 55
extend up to the inside of the treatment section 42 toward the
probe distal portion direction. In this embodiment, the suction
port 57 of the suction conduit 55 is located on the probe distal
portion direction side with respect to the ejection port 56 of the
liquid feed conduit 53.
[0063] FIG. 6 is a view illustrating the configuration of a
proximal portion of the conduit unit 50 and the transducer unit 11
in a state in which the conduit unit 50 is coupled to the probe 41,
holding unit 3 and transducer unit 11. FIG. 7 is a view
illustrating a configuration in which the conduit unit 50 is
detachably coupled to the probe 41, holding unit 3 and transducer
unit 11. As illustrated in FIG. 6, in the state in which the
conduit unit 50 is coupled to the probe 41, holding unit 3 and
transducer unit 11, the liquid feed conduit 53 (liquid feed tube
51) and suction conduit 55 (suction tube 52) extend from the
proximal direction to the distal direction through the space
portion 36 formed in the inside of the connection member 32 and in
the inside of the vibration damping member 33, and through the
cavity portion 28 formed in the inside of the horn member 26 and in
the inside of the elements-attached member 25. Further, the liquid
feed conduit 53 (liquid feed tube 51) and suction conduit 55
(suction tube 52) extend toward the probe distal portion direction,
up to the distal portion of the hollow portion 46 of the probe
41.
[0064] As illustrated in FIG. 5 to FIG. 7, the conduit unit 50
includes a cylindrical tube fixing member (liquid feed tube fixing
member) 61 to which a proximal end of the liquid feed tube 51 is
fixed by adhesion or the like. A cylindrical relay member 62 is
attached to the tube fixing member 61. A tube fixing member
(suction tube fixing member) 63 is fixed to the relay member 62.
The suction tube 52 extends toward the probe proximal portion
direction through the inside of the tube fixing member 61, and a
proximal end of the suction tube 52 is fixed to the tube fixing
member 63 by adhesion or the like.
[0065] In addition, in the conduit unit 50, a liquid feed relay
path 65 is formed by the tube fixing member 61, relay member 62 and
tube fixing member 63, and a suction relay path 66 is formed by the
tube fixing member 63. A distal end of the liquid feed relay path
65 communicates with a proximal end of the liquid feed conduit 53,
and a distal end of the suction relay path 66 communicates with a
proximal end of the suction conduit 55. In addition, a connection
mouthpiece (liquid feed mouthpiece) 67 and a connection mouthpiece
(suction mouthpiece) 68 are fixed to the tube fixing member 63.
[0066] A female screw portion 71A is formed in the relay member 62.
In addition, a male screw portion 71B is formed on the connection
member 32 of the transducer unit 11. When the conduit unit 50 is
coupled to the holding unit 3 and transducer unit 11, the liquid
feed tube 51 (liquid feed conduit 53) and the suction tube 52
(suction conduit 55) are inserted through the space portion 36 and
cavity portion 28 from the probe proximal portion direction side.
Then, in the inside of the cylindrical case portion 5 of the
holding unit 3, the liquid feed tube 51 (liquid feed conduit 53)
and the suction tube 52 (suction conduit 55) are inserted into the
hollow portion 46 of the probe 41 from the probe proximal portion
direction side, and the female screw portion 71A of the relay
member 62 is engaged with the male screw portion 71B of the
connection member 32. Thereby, the conduit unit 50 is detachably
coupled to the probe 41, holding unit 3 and transducer unit 11.
Specifically, the female screw portion 71A of the relay member 62
and the male screw portion 71B of the connection member 32 serve as
a conduit attachment/detachment portion which detachably couples
the liquid feed conduit 53 and suction conduit 55 to the probe 41
and holding unit 3. In the meantime, by varying the fastening
degree (loosening degree) between the female screw portion 71A and
male screw portion 71B, the entirety of the conduit unit 50
(including the liquid feed conduit 53 and suction conduit 55) moves
relative to the probe 41 in the longitudinal direction.
Accordingly, by adjusting the fastening degree between the female
screw portion 71A and male screw portion 71B, the positions of the
ejection port 56 of liquid feed conduit 53 and the suction port 57
of suction conduit 55 relative to the probe 41 in the longitudinal
direction are adjusted in the hollow portion 46 in the inside of
the treatment section 42 (in the inside of the probe 41).
[0067] In addition, a female screw portion 72A is formed in the
relay member 62, and a male screw portion 72B is formed on the tube
fixing member 61. By engaging the female screw portion 72A with the
male screw portion 72B, the relay member 62 is attached to the tube
fixing member 61. In addition, by varying the fastening degree
(loosening degree) between the female screw portion 72A and male
screw portion 72B, the liquid feed conduit 53 moves relative to the
suction conduit 55 in the longitudinal direction. Accordingly, by
adjusting the fastening degree between the female screw portion 72A
and male screw portion 72B, the position of the ejection port 56 of
liquid feed conduit 53 relative to the suction port 57 of suction
conduit 55 in the longitudinal direction is adjusted in the hollow
portion 46 in the inside of the treatment section 42 (in the inside
of the probe 41).
[0068] As illustrated in FIG. 1, one end of an external liquid feed
tube 73 is connectable to the connection mouthpiece (liquid feed
mouthpiece) 67 of the conduit unit 50. By the external liquid feed
tube 73 being connected to the connection mouthpiece 67, the inside
of the external liquid feed tube 73 communicates with a proximal
end of the liquid feed relay path 65. In addition, one end of an
external suction tube 75 is connectable to the connection
mouthpiece (suction mouthpiece) 68 of the conduit unit 50. By the
external suction tube 75 being connected to the connection
mouthpiece 68, the inside of the external suction tube 75
communicates with a proximal end of the suction relay path 66.
[0069] The other end of the external liquid feed tube 73 is
connected to a liquid feed source 76. The liquid feed source 76
includes a liquid feed actuation section 77 such as a liquid feed
pump, and a liquid storage tank 78. The liquid feed actuation
section 77 is electrically connected to the controller 18 of the
energy source unit 15, and the actuation state of the liquid feed
actuation section 77 is controlled by the controller 18. By the
liquid feed actuation section 77 being actuated, a liquid, such as
physiological saline, which is stored in the liquid storage tank
78, is supplied (fed) to the liquid feed conduit 53 through the
inside of the external liquid feed tube 73 and the liquid feed
relay path 65. In addition, in the liquid feed conduit 53, the
liquid is supplied from the probe proximal portion direction to the
probe distal portion direction.
[0070] The other end of the external suction tube 75 is connected
to a suction source 81. The suction source 81 includes a suction
actuation section 82 such as a suction pump, and a collection tank
83. The suction actuation section 82 is electrically connected to
the controller 18 of the energy source unit 15, and the actuation
state of the suction actuation section 82 is controlled by the
controller 18. By the suction actuation section 82 being actuated,
a flow (suction force) toward the suction source 81 occurs in the
inside of the external suction tube 75, the suction relay path 66
and suction conduit 55. Specifically, by the suction actuation
section 82 being actuated, a flow toward the probe proximal portion
direction occurs in the suction conduit 55.
[0071] In the inside of the cylindrical case portion 5 (the inside
of the holding unit 3), switch portions (not shown) are provided in
association with the respective energy operation input buttons 9A
to 9C. The respective switch portions are electrically connected to
the controller 18 of the energy source unit 15 via corresponding
signal path portions (not shown). Each signal path portion is
formed of an electric conductor portion (not shown) of the
transducer case 12, and an electric signal line (not shown) which
extends in the inside of the cable 13. In addition, the energy
operation input switch 10 is electrically connected to the
controller 18 of the energy source unit 15. By an energy operation
being input by each energy operation input button, 9A to 9C (that
is, by each energy operation input button, 9A to 9C, being
pressed), the corresponding switch portion is closed, and an
electric signal is transmitted to the controller 18 through the
corresponding signal path portion. In addition, by an energy
operation being input by the energy operation input switch 10 (that
is, by the energy operation input switch 10 being pressed), an
electric signal is transmitted from the energy operation input
switch 10 to the controller 18.
[0072] Based on the input of the energy operation (the transmitted
electric signal), the controller 18 controls the output state of
energy (ultrasonic electric power and high-frequency electric
power) from the energy source unit 15. In addition, based on the
input of the energy operation (the transmitted electric signal),
the controller 18 controls the actuation state of the liquid feed
actuation section 77 and the actuation state of the suction
actuation section 82. For example, if an energy operation is input
by the energy operation input button 9A, energy is output from the
energy source unit 15 in a first output mode. If an energy
operation is input by the energy operation input button 9B, energy
is output from the energy source unit 15 in a second output mode.
Besides, if an energy operation is input by the energy operation
input button 9C, energy is output from the energy source unit 15 in
a third output mode. If an energy operation is input by the energy
operation input switch 10, energy is output from the energy source
unit 15 in a fourth output mode. A description will be given later
of the output states of energy from the energy source unit 15 in
the first output mode to the fourth output mode, and the actuation
state of the liquid feed actuation section 77 and the actuation
state of the suction actuation section 82 in the respective output
modes.
[0073] In addition, as illustrated in FIG. 1, the energy treatment
system 1 includes a state setting unit 85. The state setting unit
85 is electrically connected to the controller 18 of the energy
source unit 15. The state setting unit 85 is, for example, a touch
panel, a button unit, etc.
[0074] FIG. 8 is a view illustrating the configuration of the state
setting unit 85. As illustrated in FIG. 8, the state setting unit
85 includes liquid feed switch portions 86A to 86D, suction switch
portions 87A to 87D, supply amount setting portions 88A to 88D, and
supply amount display portions 89A to 89D. In each liquid feed
switch portion, 86A to 86D, setting is executed as to whether the
liquid feed actuation section 77 is actuated in the corresponding
output mode (one of the first output mode to fourth output mode).
For example, in the liquid feed switch portion 86A, setting is
executed as to whether the liquid feed actuation section 77 is
actuated in the first output mode. In each suction switch portion,
87A to 87D, setting is executed as to whether the suction actuation
section 82 is actuated in the corresponding output mode (one of the
first output mode to fourth output mode). For example, in the
suction switch portion 87A, setting is executed as to whether the
suction actuation section 82 is actuated in the first output
mode.
[0075] Besides, in each supply amount setting portion, 88A to 88D,
when the liquid feed actuation section 77 is actuated in the
corresponding output mode (one of the first output mode to fourth
output mode), the supply amount (liquid feed amount) of liquid from
the liquid feed actuation section 77 in the corresponding output
mode is set. Then, the supply amount of liquid, which was set by
each of the supply amount setting portions, 88A to 88D, is
displayed on the corresponding supply amount display portion
(corresponding one of 89A to 89D). For example, in the supply
amount setting portion 88A, the supply amount of liquid from the
liquid feed actuation section 77 in the first output mode, at a
time when the liquid feed actuation section 77 is actuated in the
first output mode, is set, and the set supply amount is displayed
on the supply amount display portion 89A. Based on the setting in
the state setting unit 85, the controller 18 controls the actuation
state of the liquid feed actuation section 77 and the actuation
state of the suction actuation section 82 in each of the first
output mode to the fourth output mode.
[0076] As illustrated in FIG. 4, the treatment section 42 includes
a probe distal wall 91 which forms the distal end of the probe 41.
In addition, the outer surface of the treatment section 42 includes
a treatment section distal surface 92 which is formed by the probe
distal wall 91, and a treatment section side surface 93 which
extends from the treatment section distal surface 92 toward the
probe proximal portion direction. The treatment section distal
surface 92 forms the distal end of the probe 41, and serves as a
distal surface of the probe 41. In addition, the treatment section
side surface 93 serves as an outer peripheral surface of the
treatment section 42. In the present embodiment, the opening
portion 47 of the hollow portion 46 is located on the treatment
section distal surface 92 of the probe 41. In addition, the
ejection port 56 of the liquid feed conduit 53 and the suction port
57 of the suction conduit 55 are located in the hollow portion 46
in the inside of the probe 41. Accordingly, the jet port 56 and
suction port 57 are located on the probe proximal portion direction
side with respect to the opening portion 47 of the hollow portion
46. Besides, the treatment section side surface 93 includes a
probe-side counter-surface 95 which is opposed to the jaw 43. The
probe-side counter-surface 95 faces toward the opening direction of
the jaw 43 (the direction of arrow Y1 in FIG. 4). Incidentally, in
FIG. 4, the direction of arrow Y2 is a closing direction of the jaw
43.
[0077] The suction actuation section 82 is actuated, and a flow
(suction force) toward the probe proximal portion direction occurs
in the suction conduit 55. Thereby, suction force Fl occurs from
the outside of the probe 41 toward the suction conduit 55 through
the opening portion 47 of the hollow portion 46 and the suction
port 57. In addition, the liquid feed actuation section 77 is
actuated, and a liquid is supplied toward the probe distal portion
direction in the liquid feed conduit 53. Thereby, the liquid
supplied in the hollow portion 46 is ejected from the ejection port
56 toward the probe distal portion direction side.
[0078] The probe distal wall 91 of the treatment section 42 is
provided with a collision surface (circulation flow causing
portion) 96. The collision surface 96 faces toward the probe
proximal portion direction, and is opposed to at least a part of
the ejection port 56 of the liquid feed conduit 53. Specifically,
at least a part of the ejection port 56 is not opposed to the
opening portion 47 of the hollow portion 46, and is opposed to the
collision surface 96 of the probe distal wall 91. In this
embodiment, the collision surface 96 is located on the probe distal
portion direction side with respect to the ejection port 56 and
suction port 57.
[0079] Since the collision surface 96 is opposed to at least a part
of the ejection port 56, at least part of the liquid, which was
ejected from the ejection port 56, collides with the collision
surface 96 in the hollow portion 46. By the collision with the
collision surface 96, the direction of the flow of liquid is
changed to such a state that the liquid flows toward the probe
proximal portion direction. Specifically, part of the liquid is
caused to stay in the hollow portion 46 by the collision surface
96. When the suction actuation section 82 is actuated and suction
force is occurring, part of the liquid ejected from the ejection
port 56 flows toward the suction conduit 55 from the collision
surface 96 through the suction port 57. Specifically, in the hollow
portion 46, a flow (arrow X1 in FIG. 4) of liquid is formed toward
the suction conduit 55 from the collision surface 96 through the
suction port 57. In addition, in this embodiment, part of the
liquid ejected from the ejection port 56 does not collide with the
collision surface 96, and is ejected to the outside of the probe 41
through the opening portion 47 of the hollow portion 46 (arrow X2
in FIG. 4). Specifically, the actuation state of the liquid feed
actuation section 77 and the actuation state of the suction
actuation section 82 are controlled and the shapes, positions and
dimensions of the collision surface 96 and opening portion 47 are
designed, in such a state that part of the liquid ejected from the
ejection port 56 is ejected to the outside of the probe 41 from the
opening portion 47.
[0080] Next, the functions and advantageous effects of the energy
treatment unit 30, energy treatment instrument 2 and energy
treatment system 1 of the present embodiment will be described.
When a treated target, such as a biological tissue, is treated by
the energy treatment system 1, the conduit unit 50 is coupled to
the holding unit 3 and transducer unit 11 by the conduit
attachment/detachment portion (the female screw portion 71A of the
relay member 62 and the male screw portion 71B of the connection
member 32). Then, the cable 13 is connected to the energy supply
unit 15. In addition, the conduit unit 50 is connected to the
liquid feed source 76 by the external liquid feed tube 73, and the
conduit unit 50 is connected to the suction source 81 by the
external suction tube 75. In this state, the treatment section 42
and jaw 43 are inserted into the body.
[0081] For example, in a certain treatment, a treated target is
disposed between the treatment section 42 and jaw 43, and the
movable handle 7 is closed relative to the stationary handle 6.
Thereby, the jaw 43 is closed relative to the treatment section 42,
and the treated target is grasped between the treatment section 42
and jaw 43. In this state, an energy operation is input by the
energy operation input button 9A, and energy is output from the
energy source unit 15 in the first output mode. In the first output
mode, ultrasonic electric power is supplied to the ultrasonic
transducer 21 from the ultrasonic energy source 16, and ultrasonic
vibration is caused by the ultrasonic transducer 21. Then, the
caused vibration is transmitted to the treatment section 42 via the
ultrasonic probe 41 (vibrating body unit 20). In addition, in the
first output mode, high-frequency electric power is output from the
high-frequency energy source 17. Then, the high-frequency electric
power is supplied to the treatment section 42 through the
probe-side electricity supply path P1, and the high-frequency
electric power is supplied to the electric conductor portion (not
shown) of the jaw 43 through the jaw-side electricity supply path
P2. Thereby, the treatment section 42 and the electric conductor
portion of the jaw 43 function as electrodes with mutually
different electric potentials. In the state in which the treated
target is grasped between the jaw 43 and treatment section 42, the
treatment section 42 longitudinally vibrates, and thereby
frictional heat occurs between the treatment section 42 and the
treated target. By the frictional heat, the treated target is
coagulated and, at the same time, cut. In addition, in the state in
which the treated target is grasped between the jaw 43 and
treatment section 42, the treatment section 42 and the electric
conductor portion of the jaw 43 function as the electrodes.
Thereby, a high-frequency current flows between the treatment
section 42 and the electric conductor portion of the jaw 43 via the
treated target. Thereby, the treated target is denatured, and
coagulation is promoted.
[0082] Additionally, in another treatment, an energy operation is
input by the energy operation input button 9B, and energy is output
from the energy source unit 15 in the second output mode. In the
second output mode, the high-frequency electric power is supplied
to the treatment section 42 through the probe-side electricity
supply path P1, and the high-frequency electric power is supplied
to the electric conductor portion (not shown) of the jaw 43 through
the jaw-side electricity supply path P2. Thereby, the treatment
section 42 and the electric conductor portion of the jaw 43
function as electrodes with mutually different electric potentials,
and a bipolar treatment is performed in which a high-frequency
current is passed between the treatment section 42 and the electric
conductor portion of the jaw 43 via the treated target. In the
meantime, in the second output mode, no ultrasonic electric power
is output from the ultrasonic energy source 16, nor does ultrasonic
vibration occur.
[0083] Additionally, in another treatment, an energy operation is
input by the energy operation input button 9C, and energy is output
from the energy source unit 15 in the third output mode. In the
third output mode, high-frequency electric power is supplied to the
treatment section 42 through the probe-side electricity supply path
P1, and high-frequency electric power is supplied to a
counter-electrode plate (not shown) which is disposed outside the
body. At this time, no high-frequency electric power is supplied to
the electric conductor portion (not shown) of the jaw 43 through
the jaw-side electricity supply path P2. Thereby, a monopolar
treatment is performed in which a high-frequency current is passed
between the treatment section 42 and the counter-electrode plate on
the outside of the body via the treated target. In the meantime, in
the third output mode, no ultrasonic electric power is output from
the ultrasonic energy source 16, nor does ultrasonic vibration
occur.
[0084] When the state setting unit 85 is set in standard setting
(initial setting), neither the liquid feed actuation section 77 nor
the suction actuation section 82 is actuated in each of the first
output mode to the third output mode. However, by changing the
setting from the standard state by the state setting unit 85, the
liquid feed actuation section 77 can be actuated and the suction
actuation section 82 can be actuated in each of the first output
mode to the third output mode. In each of the first output mode to
the third output mode, when the liquid feed actuation section 77 is
actuated, the supply amount of liquid from the liquid feed
actuation section 77 can be adjusted.
[0085] Additionally, aside from the energy operation input sections
(9A to 9C, and 10), a liquid feed operation input section and a
suction operation input section may be provided. The liquid feed
operation input section and suction operation input section are,
for example, operation input buttons which are provided on the
energy treatment instrument 2, or footswitches which are separated
bodies from the energy treatment instrument 2. In this case, by a
liquid feed operation being input by the liquid feed operation
input section, the liquid feed actuation unit 77 is actuated, and
liquid is supplied to the liquid feed conduit 53. At this time, no
energy is output from the energy source unit 15, nor is the suction
actuation unit 82 actuated. In short, only the ejecting of liquid
from the ejection port 56 is performed. Besides, by a suction
operation being input by the suction operation input section, the
suction actuation unit 82 is actuated, and a flow toward the probe
proximal portion direction occurs in the suction conduit 55. At
this time, no energy is output from the energy source unit 15, nor
is the liquid feed actuation unit 77 actuated. In short, only the
suction through the suction port 57 is performed.
[0086] Additionally, in another treatment, an energy operation is
input by the energy operation input switch 10, and energy is output
from the energy source unit 15 in the fourth output mode. In the
fourth output mode, ultrasonic electric power is supplied to the
ultrasonic transducer 21 from the ultrasonic energy source 16, and
ultrasonic vibration is caused by the ultrasonic transducer 21.
Then, the caused vibration is transmitted to the treatment section
42 via the ultrasonic probe 41 (vibrating body unit 20). When the
state setting unit 85 is set in the standard setting (initial
setting), the liquid feed actuation section 77 is actuated and the
suction actuation section 82 is actuated in the fourth output mode.
Thus, liquid is supplied toward the probe distal portion direction
in the liquid feed conduit 53, and the liquid, which has been
supplied toward the probe distal portion direction, is ejected from
the ejection port 56 in the hollow portion 46. In addition, part of
the liquid ejected from the ejection port 56 is ejected from the
opening portion 47 of the hollow portion 46 to the outside of the
probe 41 (arrow X2 in FIG. 4).
[0087] In the state in which the treatment section 42 (probe 41) is
longitudinally vibrating at high speed, the liquid is supplied to
the vicinity of the treatment section distal surface 92, and
thereby cavitation occurs near the treatment section distal surface
92. By the cavitation occurring in the state in which the treatment
section distal surface 92 is opposed to the treated target, the
treated target is crushed and emulsified. In the meantime, by the
cavitation, only a biological tissue with low resiliency, such as
hepatic cells, is selectively crushed, and a biological tissue with
resiliency, such as a blood vessel, is not crushed.
[0088] In the present embodiment, liquid is supplied through the
liquid feed conduit 53 which extends in the inside of the hollow
portion 46, and the supplied liquid is ejected from the ejection
port 56 in the hollow portion 46. Then, part of the liquid ejected
from the ejection port 56 is jetted to the outside of the probe 41
from the hollow portion 46 through the opening portion 47 which is
located on the treatment section distal surface 92. Thus, the
liquid supplied from the liquid feed source 76 does not drop, for
example, from the proximal portion of the treatment section 42 to a
region other than the treated target, and the liquid is properly
supplied to the vicinity of the treatment section distal surface 92
on the outside of the probe 41. Thereby, cavitation properly
occurs, and the treated target can properly be crushed and
emulsified.
[0089] Additionally, the ejection port 56 of the liquid feed
conduit 53 is located on the probe proximal portion direction side
with respect to the opening portion 47. Accordingly, part of the
liquid, which has been ejected from the ejection port 56 to the
probe distal portion direction side in the hollow portion 46, is
properly ejected from the opening portion 47 to the outside of the
probe 41. Therefore, liquid can exactly be supplied to the vicinity
of the treatment section distal surface 92 on the outside of the
probe 41, and the treatment performance of the treatment of
crushing and emulsifying the treated target can be enhanced.
[0090] FIG. 9 illustrates a variation with time of longitudinal
vibration at a certain position of the treatment section 42 (at a
position different from a node position of longitudinal vibration)
in a state in which energy is being output in the fourth output
mode from the energy source unit 15. As illustrated in FIG. 9, in
the state in which energy is being output in the fourth output mode
from the energy source unit 15, the amplitude of the treatment
section 42 is not constant with the passing of time. Specifically,
in the fourth output mode, the ultrasonic electric power, which is
output from the ultrasonic energy source 16, is modulated by the
controller 18. For example, the modulation is executed by varying,
with the passing of time, the amplitude, cycle, etc. of electric
current (AC current) which is supplied to the ultrasonic transducer
21. By the ultrasonic electric power being modulated, the amplitude
of longitudinal vibration varies with time, for example, in such a
state that vibration occurs with a first amplitude V1, or vibration
occurs with a second amplitude V2 that is less than the first
amplitude V1, at a certain position of the treatment section 42. In
addition, by the ultrasonic electric power being modulated, for
example, the cycle of longitudinal vibration varies with time.
Besides, in the case where the amplitude of longitudinal vibration
varies with time in the state in which vibration occurs with the
first amplitude V1 or in the state in which vibration occurs with
the second amplitude V2, the ratio of a time T1, during which
vibration occurs with the first amplitude V1, in a fixed time
.DELTA.T, or the ratio of a time T2, during which vibration occurs
with the amplitude V2, in the fixed time .DELTA.T, is defined as
"duty ratio". For example, the duty ratio varies with time by the
ultrasonic electric power being modulated.
[0091] A blood vessel or the like extends in the inside of hepatic
cells, which are crushed by cavitation. By modulating the
ultrasonic electric power and varying with time the vibration state
of the treatment section 42, damage to the blood vessel extending
in the inside of hepatic cells can effectively be prevented, even
when the hepatic cells are crushed and emulsified by the
cavitation.
[0092] Additionally, in the fourth output mode, since the suction
actuation section 82 is actuated, a flow toward the probe proximal
portion direction occurs in the suction conduit 55. Thereby,
suction force (arrow Fl in FIG. 4) acts toward the suction conduit
55 from the outside of the probe 41 through the opening portion 47
of the hollow portion 46 and the suction port 57. Thereby, the
treated target, which was shattered and emulsified by the
cavitation, is sucked toward the suction conduit 55 through the
opening portion 47 and suction port 57. Then, the sucked object
(crushed and emulsified treated target) is sucked in the suction
conduit 55 toward the probe proximal portion direction, and the
sucked object is collected in the collection tank 83 of the suction
source 81.
[0093] In the present embodiment, the opening portion 47 of the
hollow portion 46 is provided on the treatment section distal
surface 92 which is different from the probe-side counter-surface
95 that is opposed to the jaw 43. Thus, the opening portion 47 is
not closed by the jaw 43. Therefore, the crushed and emulsified
treated target (sucked object) can be sucked into the suction
conduit 55 through the opening portion 47.
[0094] Additionally, the suction port 57 of the suction conduit 55
is located on the probe proximal portion direction side with
respect to the opening portion 47. Accordingly, the sucked object,
which was sucked in the hollow portion 46 from the opening portion
47, is properly sucked into the suction conduit 55 from the suction
port 57, and the suction performance of the crushed and emulsified
treated target (sucked object) can be enhanced.
[0095] Additionally, by using the energy (ultrasonic vibration,
high-frequency electric power) in the treatment, heat, such as the
above-described frictional heat, due to the ultrasonic vibration
occurs in the probe 41. Thus, the temperature of the probe 41 (in
particular, treatment section 42) becomes high due to the produced
heat, and also the temperature of the suction conduit 55, which
extends in the hollow portion 46 in the inside of the probe 14,
becomes high. By the high temperature of the suction conduit 55,
the sucked object, which is sucked through the suction conduit 55,
is burnt, and the burnt sucked object tends to be easily adhere to
the inner peripheral surface of the suction conduit 55 (the inner
peripheral surface of the suction tube 52). By the sucked object
(crushed biological tissue or the like) adhering to the inner
peripheral surface of the suction conduit 55, clogging occurs in
the suction conduit 55.
[0096] Taking the above into account, in the present embodiment,
the probe distal wall 91 is provided with the collision surface 96,
and the collision surface 96 is opposed to at least a part of the
ejection port 56. Thus, in the hollow portion 46, part of the
liquid ejected from the ejection port 56 collides with the
collision surface 96, and the direction of the flow of liquid is
changed to such a state that the liquid flows toward the probe
proximal portion direction. Thereby, in the hollow portion 46, a
flow (arrow X1 in FIG. 4) of liquid is formed toward the suction
conduit 55 from the collision surface 96 through the suction port
57. In addition, the liquid coming in from the suction port 57
moves in the suction conduit 55 from the probe distal portion
direction to the probe proximal portion direction. In the meantime,
part of the liquid ejected from the ejection port 56 is not caused
to collide with the collision surface 96, flows into the suction
conduit 55 through the suction port 57, and moves in the suction
conduit 55 from the probe distal portion direction to the probe
proximal portion direction. Accordingly, in the state in which the
liquid is ejected from the ejection port 56, the liquid that has
collided with the collision surface 96 flows in from the suction
port 57, and/or the liquid, without colliding with the collision
surface 96, flows in from the suction port 57 as such, and a flow
of liquid toward the probe proximal portion direction is formed
over the entire length of the suction conduit 55 (i.e. from the
suction port 57 to the proximal end of the suction conduit 55).
Since the liquid flows toward the probe proximal portion direction
from the suction port 57 (distal end) to the proximal end in the
suction conduit 55, the sucked object is not easily burnt in the
suction conduit 55. Thereby, the adhesion of the sucked object to
the inner peripheral surface of the suction conduit 55 is
prevented, and the occurrence of clogging in the suction conduit 55
can effectively be prevented.
[0097] Additionally, in this embodiment, the collision surface 96
is located on the probe distal portion direction side with respect
to the ejection port 56 of the liquid feed conduit 53 and the
suction port 57 of the suction conduit 55. In addition, the cross
section of the liquid feed conduit 53, which is perpendicular to
the longitudinal axis C, has a cylindrical shape surrounding the
outer peripheral side of the suction conduit 55, and the suction
port 57 of the suction conduit 55 is located on the probe distal
portion direction side with respect to the ejection port 56 of the
liquid feed conduit 53. By this configuration, at least part of the
liquid ejected from the ejection port 56 can exactly be caused to
collide with the collision surface 96. In addition, the liquid that
has collided with the collision surface 96 can exactly be caused to
flow into the suction conduit 55 through the suction port 57.
[0098] Additionally, in this embodiment, the conduit unit 50 is
detachable from the probe 41 and holding unit 3. Thus,. even if
clogging occurs in the suction conduit 55, the conduit unit 50 can
be detached from the probe 41 and sucked object, which is clogged
in the suction conduit 55, can be removed. Furthermore, the conduit
unit 50, in which clogging occurred in the suction conduit 55, can
be replaced with a new conduit unit 50. Specifically, in the energy
treatment instrument 2 of this embodiment, even if clogging occurs
in the suction conduit 55, it is easy to deal with the
clogging.
Modifications
[0099] In the first embodiment, the cross section of the liquid
feed conduit 53, which is perpendicular to the longitudinal axis C,
has the cylindrical shape surrounding the outer peripheral side of
the suction conduit 55, but the restriction to this is unnecessary.
In addition, in the first embodiment, only one opening portion 47
of the hollow portion 46 is provided, but the restriction to this
is unnecessary. For example, a first modification will be described
with reference to FIG. 10 and FIG. 11. FIG. 10 illustrates the
configuration of a treatment section 42 and a distal portion of a
conduit unit 50 according to this modification, and FIG. 11
illustrates a treatment section distal surface 92 of the treatment
section 42.
[0100] As illustrated in FIG. 10 and FIG. 11, in the present
modification, the liquid feed tube 51 is inserted through the
inside of the suction tube 52. Thus, the suction conduit 55 extends
between the inner peripheral surface of the suction tube 52 and the
outer peripheral surface of the liquid feed tube 51. In this
modification, too, the conduit axis (liquid feed conduit axis) S1
of the liquid feed conduit 53 and the conduit axis (suction conduit
axis) S2 of the suction conduit 55 are coaxial with the
longitudinal axis C. By adopting the above configuration, the cross
section of the liquid feed conduit 53, which is perpendicular to
the longitudinal axis C, has a circular shape about the
longitudinal axis C (conduit axis S1), and the cross section of the
suction conduit 55, which is perpendicular to the longitudinal axis
C, has a cylindrical (circular cylindrical) shape surrounding the
outer peripheral side of the liquid feed conduit 53. In addition,
in this modification, the ejection port 56 of the liquid feed
conduit 53 is located on the probe distal portion direction side
with respect to the suction port 57 of the suction conduit 55.
[0101] In this modification, too, the probe distal wall 91 of the
treatment section 42 is provided with a collision surface 96. The
collision surface 96 faces toward the probe proximal portion
direction, and is opposed to at least a part of the ejection port
56 of the liquid feed conduit 53.
[0102] In addition, the collision surface 96 is located on the
probe distal portion direction side with respect to the ejection
port 56 and suction port 57. Thus, in the hollow portion 46, at
least part of the liquid, which was ejected from the ejection port
56, collides with the collision surface 96. Thereby, in the hollow
portion 46, a flow (arrow X1 in FIG. 10) is formed, by which at
least part of the liquid ejected from the ejection port 56 flows
toward the suction conduit 55 from the collision surface 96 through
the suction port 57.
[0103] Additionally, in this modification, the longitudinal axis C,
which is coaxial with the conduit axis S1 of the liquid feed
conduit 53, passes through the collision surface 96. It is thus
easy to cause at least part of the liquid ejected from the ejection
port 56 to collide with the collision surface 96.
[0104] As illustrated in FIG. 11, in this modification, two
(plural) opening portions 47A and 47B are provided on the treatment
section distal surface 92. The hollow portion 46 is open to the
outside of the probe 41 at the opening portions 47A and 47B. The
opening portions 47A and 47B are located at positions on the
treatment section distal surface 92, where the longitudinal axis C
(conduit axis S1 of the liquid feed conduit 53) does not pass. In
addition, in this modification, the opening portions 47A and 47B
are disposed to be spaced apart from each other over about
180.degree. around the longitudinal axis C.
[0105] Like the first embodiment, the treated target (biological
tissue), which was crushed and emulsified by cavitation, is sucked
in the hollow portion 46 through the opening portions 47A and 47B.
In this modification, since the opening portions 47A and 47B are
located at positions on the treatment section distal surface 92,
where the conduit axis S1 of the liquid feed conduit 53 does not
pass, the sucked object (biological tissue or the like) coming into
the hollow portion 46 is effectively prevented from flowing into
the liquid feed conduit 53 from the ejection port 56.
[0106] Additionally, when the treated target is coagulated and, at
the same time, cut by ultrasonic vibration, there is a case in
which, after the treatment section 42 and jaw 43 are pierced into
the biological tissue (hepatic cells), the jaw 43 is closed
relative to the treatment section 42 and the grasped treated target
is treated. In this treatment, in the state in which the treatment
section 42 is pierced into the treated target, the treated target
is grasped between the treatment section 42 and jaw 43, and the
grasped biological tissue is coagulated and, at the same time, cut
by ultrasonic vibration. In this modification, since the opening
portions 47A and 47B are located at positions on the treatment
section distal surface 92, where the conduit axis S1 of the liquid
feed conduit 53 does not pass, the biological tissue is effectively
prevented from entering the liquid feed conduit 53 from the
ejection port 56, when the treatment section 42 is pierced into the
biological tissue (hepatic cells) in the treatment.
[0107] Additionally, as illustrated in FIG. 12 as a second
modification, four opening portions 47A to 47D may be provided on
the treatment section distal surface 92. In the present
modification, like the first modification, in the hollow portion
46, the liquid feed tube 51 is inserted through the suction tube
52, and the conduit axis S1 of the liquid feed conduit 53 is
coaxial with the longitudinal axis C. Each opening portion, 47A to
47D, is disposed to be spaced apart from neighboring opening
portions (two of 47A to 47D) over about 90.degree. around the
longitudinal axis C. In this modification, like the first
modification, the longitudinal axis C, which is coaxial with the
conduit axis S1 of the liquid feed conduit 53, passes through the
collision surface 96. Thus, the collision surface 96 is opposed to
at least a part of the ejection port 56 of the liquid feed conduit
53. In addition, like the first modification, the opening portions
47A top 47D are located at positions on the treatment section
distal surface 92, where the longitudinal axis C (conduit axis S1)
does not pass.
[0108] Additionally, as illustrated in FIG. 13 as a third
modification, two opening portions 47A and 47B, which are formed in
slit shapes extending in a direction around the longitudinal axis
C, may be provided on the treatment section distal surface 92. In
the present modification, like the first modification, in the
hollow portion 46, the liquid feed tube 51 is inserted through the
suction tube 52, and the conduit axis S1 of the liquid feed conduit
53 is coaxial with the longitudinal axis C. Each opening portion,
47A, 47B, extends over an angular range of about 120.degree. around
the longitudinal axis C. The opening portions 47A and 47B are
located to be spaced apart from each other over about 180.degree..
In this modification, like the first modification, the longitudinal
axis C, which is coaxial with the conduit axis S1 of the liquid
feed conduit 53, passes through the collision surface 96. Thus, the
collision surface 96 is opposed to at least a part of the ejection
port 56 of the liquid feed conduit 53. In addition, like the first
modification, the opening portions 47A and 47B are located at
positions on the treatment section distal surface 92, where the
longitudinal axis C (conduit axis S1) does not pass.
[0109] Additionally, in the above-described embodiment, etc., one
of the liquid feed tube 51 and suction tube 52 is inserted through
the other of the liquid feed tube 51 and suction tube 52. However,
the restriction to this is unnecessary. For example, as illustrated
in FIG. 14 as a fourth modification, in the hollow portion 46, the
suction tube 52 extends in the outside of the liquid feed tube 51,
and the liquid feed tube 51 extends in the outside of the suction
tube 52. Accordingly, the conduit axis S1 of the liquid feed
conduit 53 is not coaxial with the conduit axis S2 of the suction
conduit 55. In addition, in this modification, the conduit axis S1
of the liquid feed conduit 53 and the conduit axis S2 of the
suction conduit 55 are not coaxial with the longitudinal axis
C.
[0110] In this modification, too, the opening portion 47 of the
hollow portion 46 is formed on the treatment section distal surface
92. The conduit axis S2 of the suction conduit 55 passes through
the opening portion 47. Thus, the treated target, which was crushed
and emulsified by the cavitation, is made to easily flow into the
suction conduit 55, by the suction force (arrow Fl in FIG. 14)
acting toward the suction conduit 55 from the outside of the probe
41 through the opening portion 47 and suction port 57.
Additionally, in this modification, too, the probe distal wall 91
of the treatment section 42 is provided with the collision surface
96. The collision surface 96 faces toward the probe proximal
portion direction, and is opposed to at least a part of the
ejection port 56 of the liquid feed conduit 53. In addition, the
collision surface 96 is located on the probe distal portion
direction side with respect to the ejection port 56 and suction
port 57. Thus, in the hollow portion 46, at least part of the
liquid, which was ejected from the ejection port 56, collides with
the collision surface 96. Thereby, in the hollow portion 46, a flow
(arrow X1 in FIG. 14) is formed, by which at least part of the
liquid ejected from the ejection port 56 flows toward the suction
conduit 55 from the collision surface 96 through the suction port
57.
[0111] Additionally, the conduit axis S1 of the liquid feed conduit
53 passes through the collision surface 96, and the opening portion
47 is located at a position on the treatment section distal surface
92, where the conduit axis S1 of the liquid feed conduit 53 does
not pass. Thus, the sucked object (crushed and emulsified
biological tissue or the like) coming into the hollow portion 46 is
effectively prevented from flowing into the liquid feed conduit 53
from the ejection port 56.
[0112] Additionally, in the above-described embodiment, etc., the
opening portion (47; 47A, 47B; 47A to 47D) of the hollow portion 46
is provided on the treatment section distal surface 92, but the
restriction to this is unnecessary. For example, as illustrated in
FIG. 15 as a fifth modification, an opening portion 97, which is
open to the outside of the hollow portion 46, may be provided on
the treatment section side surface 93. In this modification, no
opening portion is provided on the treatment section distal surface
92. The opening portion 97 is located in the distal portion of the
treatment section 42, and is located, in this modification, in a
part facing toward the closing direction (the direction of arrow Y2
in FIG. 15) of the jaw 43. Accordingly, the opening portion 97 is
located in a position on the treatment section side surface 93,
which is other than the probe-side counter-surface 95. Thus, the
opening portion 47 is not closed by the jaw 43. Accordingly, the
treated target (sucked object), which was crushed and emulsified,
can properly be sucked into the suction conduit 55 through the
opening portion 47.
[0113] In the present modification, like the fourth modification,
in the hollow portion 46, the suction tube 52 extends in the
outside of the liquid feed tube 51, and the liquid feed tube 51
extends in the outside of the suction tube 52. In addition, in this
modification, the position of the ejection port 56 at the distal
end of the liquid feed conduit 53 agrees with the position of a
proximal end of the opening portion 97 in the longitudinal
direction which is parallel to the longitudinal axis C. Besides,
the position of the suction port 57 at the distal end of the
suction conduit 55 agrees with the position of the proximal end of
the opening portion 97 in the longitudinal direction. In the
meantime, the ejection port 56 and suction port 57 may be located
on the probe proximal portion direction side with respect to the
proximal end of the opening portion 97.
[0114] In this modification, too, the probe distal wall 91 of the
treatment section 42 is provided with the collision surface 96. The
collision surface 96 faces toward the probe proximal portion
direction, and is opposed to the entirety (at least a part) of the
ejection port 56 of the liquid feed conduit 53. In addition, the
collision surface 96 is located on the probe distal portion
direction side with respect to the ejection port 56 and suction
port 57. Thus, in the hollow portion 46, at least part of the
liquid, which was ejected from the ejection port 56, is not ejected
to the outside of the probe 41 from the opening portion 97, and
collides with the collision surface 96. Thereby, in the hollow
portion 46, a flow (arrow X1 in FIG. 15) is formed, by which at
least part of the liquid ejected from the ejection port 56 flows
toward the suction conduit 55 from the collision surface 96 through
the suction port 57.
[0115] Additionally, in this modification, too, liquid is supplied
through the liquid feed conduit 53 which extends in the inside of
the hollow portion 46, and the supplied liquid is ejected from the
ejection port 56 in the hollow portion 46. Then, part of the liquid
ejected from the ejection port 56 is ejected to the outside of the
probe 41 (arrow X2 in FIG. 15) from the hollow portion 46 through
the opening portion 97 which is located on the treatment section
side surface 93. The opening portion 97 is located at a
probe-distal-portion-direction-side part (a distal portion of the
treatment section side surface 93) of the treatment section 42.
Thus, the liquid supplied from the liquid feed source 76 does not
drop, for example, from the proximal portion of the treatment
section 42 to a region other than the treated target, and the
liquid is properly supplied to the vicinity of the treatment
section distal surface 92 on the outside of the probe 41.
[0116] Additionally, as illustrated in FIG. 16 and FIG. 17 as a
sixth modification, two (plural) opening portions 97A and 97B may
be provided on the treatment section side surface 93. In this
modification, like the fifth modification, no opening portion is
provided on the treatment section distal surface 92. In addition,
in this modification, like the fourth modification and fifth
modification, in the hollow portion 46, the suction tube 52 extends
in the outside of the liquid feed tube 51, and the liquid feed tube
51 extends in the outside of the suction tube 52. The opening
portions 97A and 97B are located at angular positions spaced apart
from each other over about 180.degree. around the longitudinal axis
C. The positions of the opening portions 97A and 97B agree in the
longitudinal direction. In addition, the position of the ejection
port 56 at the distal end of the liquid feed conduit 53 agrees with
the position of a proximal end of the opening portion 97A (a
proximal end portion of the opening portion 97B) in the
longitudinal direction which is parallel to the longitudinal axis
C. Besides, the position of the suction port 57 at the distal end
of the suction conduit 55 agrees with the position of the proximal
end of the opening portion 97A in the longitudinal direction. In
the meantime, the ejection port 56 and suction port 57 may be
located on the probe proximal portion direction side with respect
to the proximal end of the opening portion 97A (the proximal end
portion of the opening portion 97B).
[0117] In this modification, the opening portions 97A and 97B are
located at positions on the treatment section side surface 93 which
is other than the probe-side counter-surface 95. Incidentally, it
should suffice if at least one of the opening portions 97A and 97B
is located at a position on the treatment section side surface 93
which is other than the probe-side counter-surface 95. Thereby, at
least one of the opening portions 97A and 97B is not closed by the
jaw 43. In FIG. 16, a vertically upward direction relative to the
drawing sheet is the opening direction of the jaw 43. In addition,
FIG. 17 illustrates a cross section which extends through the
opening portions 97A and 97B and is perpendicular to the
longitudinal axis C. The direction of arrow Y1 is the opening
direction of the jaw 43, and the direction of arrow Y2 is the
closing direction of the jaw 43.
[0118] Additionally, in this modification, a plurality of opening
portions 97A and 97B are provided. Thus, even if clogging occurs in
one of the opening portions 97A and 97B due to a crushed tissue or
the like, suction into the suction conduit 55 is performed and
liquid supplied through the liquid feed conduit 53 is ejected to
the outside of the probe 41, through the other of the opening
portions 97A and 97B (the opening portion 97A or 97B in which no
clogging occurs).
[0119] Additionally, in this modification, in the opening portion
(first opening portion) 97A, the distance from the suction port 57
of the suction conduit 55 is less than the distance from the
ejection port 56 of the liquid feed conduit 53. Specifically,
compared to the ejection port 56, the suction port 57 is closer to
the opening portion 97A. Thus, the suction force (arrow Fl in FIG.
16) toward the suction conduit 55 from the outside of the probe 41
through the opening portion 97A and suction port 57 is greater than
the suction force toward the suction conduit 55 from the outside of
the probe 41 through the opening portion 97B. Accordingly, the
opening portion 97A is mainly used as an opening for causing sucked
object, such as a crushed treated target, to flow into the hollow
portion 46.
[0120] On the other hand, in the opening portion (second opening
portion) 97B, the distance from the ejection port 56 of the liquid
feed conduit 53 is less than the distance from the suction port 57
of the suction conduit 55. Specifically, compared to the suction
port 57, the ejection port 56 is closer to the opening portion 97B.
Thus, in the hollow portion 45, part of liquid ejected from the
ejection port 56 is ejected to the outside of the probe 41, mainly
through the opening portion 97B (arrow X2 in FIG. 16). Accordingly,
the opening portion 97B is mainly used as an opening for ejecting
liquid to the outside of the probe 41 and supplying liquid to the
vicinity of the treatment section distal surface 92.
[0121] As described above, in the present modification, in addition
to the opening portion (first opening portion) 97A for causing
sucked object from the outside of the probe 41 to flow into the
hollow portion 46, there is provided the opening portion (second
opening portion) 97B for ejecting liquid to the outside of the
probe 41. In addition, the opening portions 97A and 97B are located
to be spaced apart from each other. Thus, the supply performance of
liquid to the vicinity of the treatment section distal surface 92
is enhanced, and the suction performance through the suction
conduit 55 is also enhanced.
[0122] Additionally, as illustrated in FIG. 18 as a seventh
modification, four (plural) opening portions 97A to 97D may be
provided on the treatment section side surface 93. In the present
modification, like the fifth modification, no opening portion is
provided on the treatment section distal surface 92. In addition,
in this modification, like the fourth modification and fifth
modification, in the hollow portion 46, the suction tube 52 extends
in the outside of the liquid feed tube 51, and the liquid feed tube
51 extends in the outside of the suction tube 52. The positions of
the opening portions 97A to 97D agree in the longitudinal
direction. In addition, each of the opening portions 97A to 97D is
disposed to be spaced apart from neighboring opening portions
(corresponding two of 97A to 97D) over about 90.degree. around the
longitudinal axis C. In this modification, only the opening portion
97D is located on the probe-side counter-surface 95 which is
opposed to the jaw 43, and the opening portions 97A to 97C are
located at positions on the treatment section side surface 93 which
is other than the probe-side counter-surface 95.
[0123] Additionally, as illustrated in FIG. 19 as an eighth
modification, two (plural) opening portions 97A and 97B may be
provided on the treatment section side surface 93, and the opening
portions 97A and 97B may be disposed apart from each other in the
longitudinal direction. The opening portion (first opening portion)
97A is located on the probe distal portion direction side with
respect to the opening portion (second opening portion) 97B.
Compared to the ejection port 56, the suction port 57 is located
closer to the opening portion 97A. Compared to the suction port 57,
the ejection port 56 is located closer to the opening portion 97B.
Accordingly, sucked object flows into the hollow portion 46 mainly
through the opening portion 97A, and the liquid is ejected to the
outside of the probe 41 mainly through the opening portion 97B. In
the present modification, the opening portions 97A and 97B are
disposed to be spaced apart from each other over about 180.degree.
around the longitudinal axis C. However, it should suffice if the
opening portions 97A and 97B are located at angular positions
spaced apart from each other around the longitudinal axis C. For
example, the opening portions 97A and 97B may be located to be
spaced apart from each other over about 90.degree. around the
longitudinal axis C. In addition, at least one of the opening
portions 97A and 97B is located at a position on the treatment
section side surface 93 which is other than the probe-side
counter-surface 95.
[0124] In the present modification, the positions of the ejection
port 56 of the liquid feed conduit 53 and the suction port 57 of
the suction conduit 55 agree with the position of the proximal end
of the opening portion 97B in the longitudinal direction. However,
it should suffice if the position of the suction port 57 agrees
with the position of the proximal end of the opening portion (first
opening portion) 97A in the longitudinal direction, or is located
on the probe proximal portion direction side with respect to the
opening portion 97A. In addition, it should suffice if the position
of the ejection port 56 agrees with the position of the proximal
end of the opening portion (second opening portion) 97B in the
longitudinal direction, or is located on the probe proximal portion
direction side with respect to the opening portion 97B.
[0125] Additionally, as illustrated in FIG. 20 as a ninth
modification, two opening portions 47A and 47B may be provided on
the treatment section distal surface 92, and two opening portions
97A and 97B may be provided on the treatment section side surface
93. The opening portions 47A and 47B are provided on the treatment
section distal surface 92 at the same positions and with the same
shapes as in the first modification (see FIG. 10 and FIG. 11). In
addition, the opening portions 97A and 97B are provided on the
treatment section side surface 93 at the same positions and with
the same shapes as in the sixth modification (see FIG. 16 and FIG.
17). Further, in this modification, like the first modification,
the liquid feed tube 51 is inserted through the suction tube 52,
and the conduit axis S1 of the liquid feed conduit 53 is coaxial
with the longitudinal axis C. Besides, like the first modification,
the opening portions 47A and 47B are located at positions on the
treatment section distal surface 92, where the conduit axis S1
(longitudinal axis C) does not pass, and the conduit axis S1 passes
through the collision surface 96.
[0126] In the present modification, the position of the suction
port 57 at the distal end of the suction conduit 55 agrees with the
position of the proximal end of the opening portion 97A (the
proximal end of the opening portion 97B) in the longitudinal
direction, or is located on the probe proximal portion direction
side with respect to the opening portion 97A. In addition, the
position of the ejection port 56 at the distal end of the liquid
feed conduit 53 is located on the probe distal portion direction
side with respect to the opening portion 97A, and is located on the
probe proximal portion direction side with respect to the opening
portions 47A and 47B. Accordingly, in this modification, sucked
object flows into the hollow portion 46 mainly through the opening
portions 97A and 97B (arrow Fl in FIG. 20), and liquid is ejected
to the outside of the probe 41 mainly from the opening portions 47A
and 47B (arrow X2 in FIG. 20).
[0127] Additionally, in a tenth modification illustrated in FIG.
21, an opening portion 47 is provided on the treatment section
distal surface 92, and two opening portions 97A and 97B are
provided on the treatment section side surface 93. The opening
portion 47 is provided on the treatment section distal surface 92
at the same position and with the same shape as in the fourth
modification (see FIG. 14). In addition, the opening portions 97A
and 97B are provided on the treatment section side surface 93 at
the same positions and with the same shapes as in the sixth
modification (see FIG. 16 and FIG. 17). Further, in this
modification, like the fourth modification, the liquid feed tube 51
extends in the outside of the suction tube 52, and the suction tube
52 extends in the outside of the liquid feed tube 51. Besides, like
the fourth modification, the opening portion 47 is located at a
position on the treatment section distal surface 92, where the
conduit axis S1 of the liquid feed conduit 53 does not pass, and
the conduit axis S1 passes through the collision surface 96.
[0128] Additionally, in the above-described embodiment, etc.,
although both the liquid feed tube 51 and the suction tube 52
extend in the hollow portion 46, the restriction to this is
unnecessary. For example, in an eleventh modification illustrated
in FIG. 22, only the suction tube 52 extends in the hollow portion
46, and no liquid feed tube is provided. In this modification, a
liquid feed conduit 53 is formed between the outer peripheral
surface of the suction tube 52 and the inner peripheral surface of
the probe 41.
[0129] Accordingly, a ejection port 56 of the liquid feed conduit
53 is formed on the outer peripheral side of the distal end of the
suction tube 52. In this modification, too, the probe distal wall
91 of the treatment section 42 is provided with a collision surface
96, and the collision surface 96 faces toward the probe proximal
portion direction, and is opposed to at least a part of the
ejection port 56 of the liquid feed conduit 53.
[0130] Additionally, for example, in a twelfth modification
illustrated in FIG. 23, only the liquid feed tube 51 extends in the
hollow portion 46, and no suction tube is provided. In this
modification, a suction conduit 55 is formed between the outer
peripheral surface of the liquid feed tube 51 and the inner
peripheral surface of the probe 41. Accordingly, a suction port 57
of the suction conduit 55 is formed on the outer peripheral side of
the distal end of the liquid feed tube 51. In this modification,
too, the probe distal wall 91 of the treatment section 42 is
provided with a collision surface 96, and the collision surface 96
faces toward the probe proximal portion direction, and is opposed
to at least a part of the ejection port 56 of the liquid feed
conduit 53.
[0131] Additionally, for example, in a 13th modification
illustrated in FIG. 24, communication portions 101A and 101B are
provided for establishing communication between the liquid feed
conduit 53 and suction conduit 55 on the probe proximal portion
direction side with respect to the ejection port 56 and suction
port 57. In this modification, like the first embodiment, the
suction tube 52 is inserted through the liquid feed tube 51. In
addition, the opening portion 47 is provided on the treatment
section distal surface 92 at the same position and with the same
shape as in the first embodiment (see FIG. 4).
[0132] In the present modification, part of the liquid supplied
from the liquid feed actuation section 77 (liquid feed source 76)
flows from the liquid feed conduit 53 into the suction conduit 55
through the communication portions 101A and 101B (arrow X3 in FIG.
24). However, at least part of the liquid supplied from the liquid
feed actuation section 77 to the liquid feed conduit 53 does not
flow into the suction conduit 55 from the communication portions
101A and 101B, and is supplied to the ejection port 56. Then, in
the hollow portion 46, the liquid supplied to the ejection port 56
is ejected toward the probe distal portion direction side from the
ejection port 56. Specifically, the actuation states of the liquid
feed actuation section 77 and suction actuation section 82 are
controlled by the controller 18, in such a state that at least part
of the liquid supplied from the liquid feed actuation section 77
does not flow into the suction conduit 55 from the communication
portions 101A and 101B, and is ejected from the ejection port 56 in
the hollow portion 46.
[0133] At least part of the liquid ejected from the ejection port
56 collides with the collision surface 96 in the same manner as in
the first embodiment. Thereby, in the hollow portion 46, a flow
(arrow X1 in FIG. 24) is formed, by which at least part of the
liquid ejected from the ejection port 56 flows toward the suction
conduit 55 from the collision surface 96 through the suction port
57. Besides, part of the liquid ejected from the ejection port 56
does not collide with the collision surface 96, and is ejected to
the outside of the probe 41 from the opening portion 47 (arrow X2
in FIG. 24).
[0134] In the present modification, liquid flows from the liquid
feed conduit 53 into the suction conduit 55 through the
communication portions 101A and 101B. Thus, the amount of liquid
flowing in the suction conduit 55 toward the probe proximal portion
direction increases. Thereby, the viscosity of the sucked object
(crushed biological tissue or the like) lowers, and clogging less
easily occurs in the suction conduit 55. In addition, at least part
of the liquid supplied through the liquid feed conduit 53 is
supplied to the ejection port 56, and is ejected from the ejection
port 56 in the hollow portion 46. Then, at least part of the liquid
jetted from the jet port 56 collides with the collision surface 96,
and flows into the suction conduit 55 through the suction port 57.
Thus, in the suction conduit 55, the liquid flows toward the probe
proximal portion direction in the region between the suction port
57 and the communication portions 101A and 101B. Therefore, in the
present modification, too, in which the communication portions 101A
and 101B are provided, the occurrence of clogging can effectively
be prevented in the region between the suction port 57 of the
suction conduit 55 and the communication portions 101A and
101B.
[0135] Additionally, for example, also in a 14th modification
illustrated in FIG. 25, communication portions 101A and 101B are
provided for establishing communication between the liquid feed
conduit 53 and suction conduit 55 on the probe proximal portion
direction side with respect to the ejection port 56 and suction
port 57. In this modification, like the first modification, the
liquid feed tube 51 is inserted through the suction tube 52. In
addition, the opening portions 47A and 47B are provided on the
treatment section distal surface 92 at the same positions and with
the same shapes as in the first modification (see FIG. 10 and FIG.
11).
[0136] In the present modification, like the 13th modification,
part of the liquid supplied from the liquid feed actuation section
77 (liquid feed source 76) flows from the liquid feed conduit 53
into the suction conduit 55 through the communication portions 101A
and 101B (arrow X3 in FIG. 25). However, at least part of the
liquid supplied from the liquid feed actuation section 77 to the
liquid feed conduit 53 does not flow into the suction conduit 55
from the communication portions 101A and 101B, and is supplied to
the ejection port 56. Then, in the hollow portion 46, the liquid
supplied to the ejection port 56 is ejected toward the probe distal
portion direction side from the ejection port 56. At least part of
the liquid ejected from the ejection port 56 collides with the
collision surface 96 in the same manner as in the 13th
modification. Thereby, in the hollow portion 46, a flow (arrow X1
in FIG. 25) is formed, by which at least part of the liquid ejected
from the ejection port 56 flows toward the suction conduit 55 from
the collision surface 96 through the suction port 57. Besides, part
of the liquid ejected from the ejection port 56 does not collide
with the collision surface 96, and is ejected to the outside of the
probe 41 from the opening portions 47A and 47B (arrow X2 in FIG.
25).
[0137] In the meantime, also in the configuration in which only the
suction tube 52 is provided, as in the eleventh modification
illustrated in FIG. 22, the suction tube 52 may be provided with
the communication portions (101A, 101B) for establishing
communication between the liquid feed conduit 53 and suction
conduit 55 on the probe proximal portion direction side with
respect to the ejection port 56 and suction port 57. Besides, also
in the configuration in which only the liquid feed tube 51 is
provided, as in the twelfth modification illustrated in FIG. 23,
the liquid feed tube 51 may be provided with the communication
portions (101A, 101B) for establishing communication between the
liquid feed conduit 53 and suction conduit 55 on the probe proximal
portion direction side with respect to the ejection port 56 and
suction port 57.
[0138] Additionally, in the above-described embodiment, etc., the
collision surface 96 is provided in the probe distal wall 91 of the
probe 41 (treatment section 42), but the restriction to this is
unnecessary. For example, as illustrated in FIG. 26 as a 15th
modification, a projection portion 102 projecting toward the inner
peripheral side of the probe 41 may be provided on the probe
proximal portion direction side with respect to the probe distal
wall 91, and a collision surface 96 may be formed in the projection
portion 102. In this modification, too, the collision surface 96
faces toward the probe proximal portion direction, and is opposed
to at least a part of the ejection port 56 of the liquid feed
conduit 53.
[0139] Additionally, in a 16th modification illustrated in FIG. 27,
in the outside of the probe 41, an external liquid feed tube 103
may extend from the probe proximal portion direction toward the
probe distal portion direction. An external liquid feed conduit 105
is formed in the inside of the external liquid feed tube 103.
Accordingly, the external liquid feed conduit 105 extends from the
probe proximal portion direction toward the probe distal portion
direction through the outside of the probe 41. The distal end of
the external liquid feed conduit 105 is formed by an external
ejection port 107 which is located in the outside of the probe 41.
In this modification, the external ejection port 107 is located on
the probe-side counter-surface 95 of the treatment section side
surface 93 of the treatment section 42. Accordingly, the external
ejection port 107 is located on the probe distal portion direction
side with respect to the distal end of the sheath 40.
[0140] The external liquid feed conduit 105 (external liquid feed
tube 103) extends up to the inside of the holding unit 3 toward the
probe proximal portion direction, through between the outer
peripheral surface of the probe 41 and the inner peripheral surface
of the sheath 40. In this modification, one end of an external
liquid feed tube (not shown), which is different from the external
liquid feed tube 73, can be connected to the holding unit 3. By the
external liquid feed tube being connected to the holding unit 3,
the proximal end (one end) of the external liquid feed conduit 105
communicates with the inside of the external liquid feed tube.
[0141] Additionally, in the present modification, a liquid feed
source (not shown), which is different from the liquid feed source
76, is provided in the energy treatment system 1. The other end of
the external liquid feed tube is connected to the liquid feed
source. The liquid feed source, like the liquid feed source 76, is
provided with a liquid feed actuation section (not shown) such as a
liquid feed pump, and a liquid storage tank (not shown), and the
actuation state of the liquid feed actuation section is controlled
by the controller 18. By the liquid feed actuation section being
actuated, a liquid, such as physiological saline, which is stored
in the liquid storage tank, is supplied (fed) to the external
liquid feed conduit 105 through the inside of the external liquid
feed tube. In addition, in the external liquid feed conduit 105,
the liquid is supplied from the probe proximal portion direction to
the probe distal portion direction. Thereby, the supplied liquid is
ejected from the external ejection port 107 toward the probe distal
portion direction side, and the liquid is supplied to the vicinity
of the treatment section distal surface 92.
[0142] In this modification, the external ejection port 107 is
located on the probe-side counter-surface 95. Thus, by the jaw 43
being closed relative to the treatment section 42, the jet speed of
the liquid, which is ejected from the external ejection port 107,
increases. Therefore, the liquid supplied from the liquid feed
source does not drop, for example, from the proximal portion of the
treatment section 42 to a region other than the treatment target,
and the liquid is properly supplied to the vicinity of the
treatment section distal surface 92 in the outside of the probe
41.
[0143] In this modification, like the first embodiment, the suction
tube 52 is inserted through the inside of the liquid feed tube 51.
In addition, like the first embodiment, the opening portion 47 is
provided on the treatment section distal surface 92. Accordingly,
like the first embodiment, the collision surface 96, which is
provided in the probe distal wall 91, is opposed to at least a part
of the ejection port 56. By the above-described configuration, also
in the present modification, in the hollow portion 46, at least
part of the liquid, which was ejected from the ejection port 56,
collides with the collision surface 96. Thereby, in the hollow
portion 46, a flow (arrow X1 in FIG. 27) is formed, by which at
least part of the liquid ejected from the ejection port 56 flows
toward the suction conduit 55 from the collision surface 96 through
the suction port 57. In addition, part of the liquid ejected from
the ejection port 56 is ejected to the outside of the probe 41 from
the hollow portion 46 through the opening portion 47 (arrow X2 in
FIG. 27).
[0144] Additionally, in the above-described embodiment, etc., part
of the liquid, which has been ejected from the ejection port 56 of
the liquid feed conduit 53, is ejected from the opening portion
(47; 47A, 47B; 47A to 47D; 97; 97A, 97B; 97A to 97D; 47, 97A, 97B;
47A, 47B, 97A, 97B) to the outside of the probe 41, and is supplied
to the vicinity of the treatment section distal surface 92.
However, the restriction to this is unnecessary. For example, in a
17th modification illustrated in FIG. 28, the liquid ejected from
the ejection port 56 is not ejected to the outside of the probe 41.
In this modification, like the 16th modification, in addition to
the liquid feed conduit 53 which supplies liquid that is to be
caused to flow into the suction conduit 55 from the suction port
57, there is provided an external liquid feed conduit 105 which
supplies liquid, which is used for treatment, to the vicinity of
the treatment section distal surface 92 in the outside of the probe
41. In this modification, all liquid ejected from the ejection port
56 collides with the collision surface 96. Thereby, in the hollow
portion 46, a flow (arrow X1 in FIG. 28) is formed, by which all
liquid ejected from the ejection port 56 flows toward the suction
conduit 55 from the collision surface 96 through the suction port
57. By adjusting the supply amount of liquid to the ejection port
56 of the liquid feed conduit 53 by controlling the actuation state
of the liquid feed actuation section 77, all liquid ejected from
the ejection port 56 can be made to flow into the suction conduit
55 through the suction port 57.
[0145] In this modification, the liquid feed conduit 53 supplies
only the liquid that is to be caused to flow into the suction
conduit 55 from the suction port 57. In addition to the liquid feed
conduit 53, the external liquid feed conduit 105 is provided which
supplies liquid, which is used for treatment, to the vicinity of
the treatment section distal surface 92 in the outside of the probe
41. Accordingly, by controlling the actuation state of the liquid
feed actuation section 77 which supplies liquid to the liquid feed
conduit 53 and by controlling the actuation state of the liquid
feed actuation section (not shown) which supplies liquid to the
external liquid feed conduit 105, it becomes possible to cause
liquid to flow into the suction conduit 55 from the suction port
57, even in a treatment in which liquid (physiological saline) is
not used. For example, when energy is output from the energy source
unit 15 in the first output mode described in the first embodiment
(i.e. when the probe 41 transmits ultrasonic vibration and the
treatment section 42 and the electric conductor portion of the jaw
43 function as electrodes of high-frequency electric power), the
liquid feed actuation section 77, which supplies liquid to the
liquid feed conduit 53, is actuated, and the actuation of the
liquid feed actuation section, which supplies liquid to the
external liquid feed conduit 105, is stopped. Thereby, no liquid is
ejected from the external ejection port 107, and all liquid ejected
from the ejection port 56 collides with the collision surface 96
and flows into the suction conduit 55 through the suction port 57.
Accordingly, the treatment performance of the treatment, which cuts
the treated target while coagulating the treated target, does not
deteriorate due to the liquid in the outside of the probe 41, and
the occurrence of clogging in the suction conduit 55 is
prevented.
[0146] Additionally, in an 18th embodiment, the output state of
energy from the energy source unit 15, the actuation state of the
liquid feed actuation section 77 and the actuation state of the
suction actuation section 82 are controlled by the controller 18,
as illustrated in FIG. 29. FIG. 29 is a view illustrating an
example of variations with time of the presence/absence of an input
of an energy operation in the energy operation input section (9A to
9C, 10), the actuation state of the liquid feed actuation section
77, and the actuation state of the suction actuation section 82. In
FIG. 29, a solid line indicates the variation of the input of the
energy operation, a broken line indicates the variation of the
actuation state of the liquid feed actuation section 77, and a
dot-and-dash line indicates the variation of the actuation state of
the suction actuation section 82.
[0147] In the example shown in FIG. 29, the energy operation in the
energy operation input section (one of 9A to 9C, and 10) is input
between time t1 and time t2 (an input ON state of an energy
operation). When an energy operation was input by each energy
operation input section (9A to 9C, 10), energy, which is used for
treatment, is output from the energy source unit 15 in the output
mode (one of the first output mode to fourth output mode) described
in the first embodiment, and the actuation state of the liquid feed
actuation section 77 and the actuation state of the suction
actuation section 82 are controlled as described in the first
embodiment. Then, if the input of the energy operation is stopped
at time t2 (if the energy operation enters an input OFF state), the
liquid feed actuation section 77 is automatically actuated at the
same time, and liquid is supplied through the liquid feed conduit
53 (the liquid feed actuation section 77 enters an ON state). Then,
at time t3 at which a predetermined time .DELTA.W1 has passed since
time t2 at which the actuation of the liquid feed actuation section
77 was started (i.e. at which the supply of liquid from the liquid
feed source 76 was started), the suction actuation section 82 is
automatically actuated (the suction actuation section 82 enters an
ON state).
[0148] By the liquid feed actuation section 77 and suction
actuation section 82 being actuated, at least part of the liquid
ejected from the ejection port 56 collides with the collision
surface 96 in the hollow portion 46, as described above. Thereby,
in the hollow portion 46, a flow is formed, by which at least part
of the liquid ejected from the ejection port 56 flows toward the
suction conduit 55 from the collision surface 96 through the
suction port 57. Then, the liquid feed actuation section 77 is
stopped (the liquid feed actuation section 77 enters an OFF state)
after a predetermined time .DELTA.W2 has passed since time t2 (i.e.
since the actuation of the liquid feed actuation section 77 was
started). In addition, the suction actuation section 82 is stopped
(the suction actuation section 82 enters an OFF state) after a
predetermined time .DELTA.W2 has passed since time t3 (i.e. since
the actuation of the suction actuation section 82 was started).
Thus, the actuation of the suction actuation section 82 is stopped
after a predetermined time .DELTA.W1 has passed since the actuation
of the liquid feed actuation section 77 was stopped.
[0149] By the liquid feed actuation section 77 and suction
actuation section 82 being controlled as described above, the
occurrence of clogging in the suction conduit 55 can more
effectively be prevented in the treatment using energy. In the
meantime, even when the liquid feed operation or suction operation
described in the first embodiment, in place of the energy
operation, is input between time t1 and time t2, the actuation
state of the liquid feed actuation section 77 and the actuation
state of the suction actuation section 82 may be controlled with
the passing of time, as described above in the present
modification, after time t2 (i.e. after the input of the liquid
feed operation or suction operation is stopped).
[0150] Additionally, in the above-described embodiment, etc., the
treated target can be grasped between the jaw 43 and treatment
section 42 by the energy treatment instrument 2, but the
restriction to this is unnecessary. For example, in a certain
modification, the jaw 43 may not be provided. In this case, the
stationary handle 6, movable handle 7 and rotary operation knob 8
are not provided in the holding unit 3. In addition, the treatment,
by which the treated target grasped between the jaw 43 and
treatment section 42 is cut, while being coagulated, by ultrasonic
vibration, is not performed. However, in this case, too, the probe
41 transmits ultrasonic vibration as energy which is used for
treatment. In addition, in the treatment section 42 (in the
vicinity of the treatment section distal surface 92), the treated
target is crushed and emulsified by cavitation, as described above,
and the crushed and emulsified treated target is sucked through the
suction conduit 55.
[0151] Additionally, in a certain modification, the probe 41 may
not transmit ultrasonic vibration, and only high-frequency electric
power may be supplied as energy to the treatment section 42 through
the probe 41. In this case, by the high-frequency electric power
being supplied to the treatment section 42, a high-frequency
current is passed through the treated target, and the treated
target is resected by the high-frequency current. Then, the
resected treated target is sucked through the suction conduit 55
which extends through the hollow portion 46 of the probe 41.
[0152] Additionally, in a certain modification, a heat generation
body (not shown) such as a thermocouple may be provided in the
treatment section 42, and electric power may be supplied to the
heat generation body through the probe 41. By the electric power
being supplied as energy, heat, which is used in treatment, is
generated in the heat generation body. Then, using the generated
heat, the treated target is resected, and the resected treated
target is sucked through the suction conduit 55 which extends in
the hollow portion 46 of the probe 41.
[0153] Additionally, in a certain modification, the treatment
section 42 (probe distal portion) of the probe 41 may be provided
with a probe bend portion which bends in a certain direction
crossing the straight longitudinal axis C. In this case, too, like
the above-described embodiment, etc., the liquid feed conduit 53
and suction conduit 55 extend in the hollow portion 46 in the
inside of the probe 41, and the collision surface 96 is formed in
the probe 41.
[0154] In the above-described embodiment, etc., the probe (41)
extends along the longitudinal axis (C), and can transmit energy.
In addition, the probe (41) includes, in the distal portion
thereof, the treatment section (42) which performs treatment by
using the transmitted energy, and the hollow portion (46) is formed
along the longitudinal axis (C) in the inside of the probe (41).
The hollow portion (46) is open to the outside of the probe (41) at
the opening portion (47; 47A, 47B; 47A to 47D; 97; 97A, 97B; 97A to
97D; 47, 97A, 97B; 47A, 47B, 97A, 97B) on the outer surface of the
treatment section (42). In addition, in the hollow portion (46),
the liquid feed conduit (53) and suction conduit (55) extend from
the probe proximal portion direction to the probe distal portion
direction. The distal end of the suction conduit (55) is formed by
the suction port (57) which is located in the hollow portion (46),
and the distal end of the liquid feed conduit (53) is formed by the
ejection port (56) which is located in the hollow portion (46). By
a flow occurring toward the probe proximal portion direction in the
suction conduit (55), suction force acts from the outside of the
probe (41) toward the suction conduit (55) through the opening
portion (47; 47A, 47B; 47A to 47D; 97; 97A, 97B; 97A to 97D; 47,
97A, 97B; 47A, 47B, 97A, 97B) of the hollow portion (46) and the
suction port (57). In addition, by liquid being supplied toward the
probe distal portion direction in the liquid feed conduit (53), the
supplied liquid in the hollow portion (46) is ejected from the
ejection port (56) toward the probe distal portion direction side.
In the probe (41), the collision surface (96) is provided in such a
state that the collision surface (96) is opposed to at least a part
of the ejection port (56). The collision surface (96) is located on
the probe distal portion direction side with respect to the suction
port (57) and jet port (56). In the hollow portion (46), at least
part of the liquid ejected from the ejection port (56) collides
with the collision surface (96), and the direction of the flow of
the liquid, which collides with the collision surface (96), is
changed. Thereby, in the hollow portion (46), a flow of liquid is
formed toward the suction conduit (55) from the collision surface
(96) through the suction port (57).
[0155] If the above-described configuration is satisfied, proper
changes can be made to the number and shape of opening portions
(47; 47A, 47B; 47A to 47D; 97; 97A, 97B; 97A to 97D; 47, 97A, 97B;
47A, 47B, 97A, 97B), and to the states of extending of the liquid
feed conduit (53) and suction conduit (55) in the hollow portion
(46).
REFERENCE EXAMPLE
[0156] Hereinafter, a reference example will be described with
reference to FIG. 30 to FIG. 32. FIG. 30 is a view illustrating the
configuration of a probe 41 and a probe holder 117 to which the
probe 41 is fixed. As illustrated in FIG. 30, in the reference
example, the probe 41 includes a distal-side probe 112 and a
proximal-side probe 113 which is connected to a probe proximal
portion direction side of the distal-side probe 112. Time and labor
is required for a process of forming a hole which penetrates an
elongated columnar member in the longitudinal direction. Thus, by
connecting two members (e.g. the distal-side probe 112 and
proximal-side probe 113) by screwing or the like, time and labor
for manufacturing the probe 41 is reduced even when a hollow
portion 46 penetrating the probe 41 along the longitudinal axis C
is formed in the inside of the probe 41.
[0157] In this reference example, the distal-side probe 112 is
provided with a treatment section 42. FIG. 31 illustrates a cross
section perpendicular to the longitudinal axis C of the treatment
section 42. As illustrated in FIG. 31, in the cross section
perpendicular to the longitudinal axis C of the treatment section
42, the shape surrounded by the outer surface (treatment section
side surface 93) is substantially pentagonal, and is not
point-symmetric (non-point symmetric) with respect to the
longitudinal axis C.
[0158] In addition, the proximal-side probe 113 is provided with a
flange portion 115. A probe stopper member 116 is fixed to the
flange portion 115. Furthermore, the sheath 40 is provided with a
probe holder 117. By the probe stopper member 116 being fixed to
the probe holder 117, the probe 41 is attached to the sheath
40.
[0159] FIG. 32 illustrates a cross section perpendicular to the
longitudinal axis C passing through the flange portion 115 of the
probe 41 and the probe holder 117. As illustrated in FIG. 32, in
the probe 41 (proximal-side probe 113), an engaging outer
peripheral surface 118 is formed by an outer peripheral surface of
the flange portion 115. In the cross section perpendicular to the
longitudinal axis C, the shape surrounded by the engaging outer
peripheral surface 118 of the flange portion 115 is not
point-symmetric (non-point symmetric) with respect to the
longitudinal axis C. Specifically, the engaging outer peripheral
surface 118 of the flange portion 115 is formed non-point symmetric
with respect to the longitudinal axis C.
[0160] In the probe 41 in which the proximal-side probe 113 is
connected to the distal-side probe 112, the angular position around
the longitudinal axis C of the engaging outer peripheral surface
118 (flange portion 115), relative to the treatment section 42,
varies from product to product. For example, in a certain probe 41,
relative to the treatment section 42 disposed at an angular
position shown in FIG. 31 around the longitudinal axis C, the
engaging outer peripheral surface 118 is disposed at an angular
position around the longitudinal axis C, which is indicated by a
solid line in FIG. 32. However, in another probe 41, relative to
the treatment section 42 disposed at the angular position shown in
FIG. 31 around the longitudinal axis C, the flange portion 115 is
disposed at an angular position around the longitudinal axis C,
which is indicated by a broken line in FIG. 32.
[0161] In addition, an engaging inner peripheral surface 119, which
is engaged with the engaging outer peripheral surface 118, is
formed by an inner peripheral surface of the probe stopper member
116. By the engaging inner peripheral surface 119 being engaged
with the engaging outer peripheral surface 118, the probe stopper
member 116 is fixed to the probe 41 (proximal-side probe 113). In
the cross section perpendicular to the longitudinal axis C, the
engaging inner peripheral surface 119 is formed to have a shape
corresponding to the engaging outer peripheral surface 118 (a shape
engageable with the engaging outer peripheral surface 118). Thus,
in the cross section perpendicular to the longitudinal axis C, the
shape surrounded by the engaging inner peripheral surface 119 of
the probe stopper member 116 is not point-symmetric (non-point
symmetric) with respect to the longitudinal axis C. Specifically,
the engaging inner peripheral surface 119 of the probe stopper
member 116 is formed non-point symmetric with respect to the
longitudinal axis C.
[0162] When the probe stopper member 116 is fixed to the flange
portion 115 of the probe 41, the angular position around the
longitudinal axis C of the engaging inner peripheral surface 119 is
adjusted in such a state as to be engageable with the engaging
outer peripheral surface 118, in accordance with the angular
position around the longitudinal axis C of the engaging outer
peripheral surface 118. In addition, as described above, the
angular position around the longitudinal axis C of the engaging
outer peripheral surface 118 (flange portion 115), relative to the
treatment section 42, varies from product to product. Accordingly,
the angular position around the longitudinal axis C of the engaging
inner peripheral surface 119, relative to the treatment section 42,
varies from product to product.
[0163] Additionally, a projection-and-recess outer peripheral
surface 121 is formed on the outer peripheral surface of the probe
stopper member 116 over the entire circumference around the
longitudinal axis C. In the cross section perpendicular to the
longitudinal axis C, the shape surrounded by the
projection-and-recess outer peripheral surface 121 of the probe
stopper member 116 is point-symmetric with respect to the
longitudinal axis C. Specifically, the projection-and-recess outer
peripheral surface 121 of the probe stopper member 116 is formed
point-symmetric with respect to the longitudinal axis C.
[0164] Thus, even if the angular position around the longitudinal
axis C of the engaging inner peripheral surface 119 (probe stopper
member 116) varies, the cross-sectional shape perpendicular to the
longitudinal axis C of the projection-and-recess outer peripheral
surface 121 does not change.
[0165] The probe holder 117 includes holder forming members 122A
and 122B. In addition, a projection-and-recess inner peripheral
surface 123 is formed on the inner peripheral surface of the probe
holder 117 over the entire circumference around the longitudinal
axis C. In the cross section perpendicular to the longitudinal axis
C, the projection-and-recess inner peripheral surface 123 is formed
to have a shape corresponding to the projection-and-recess outer
peripheral surface 121 (a shape engageable with the
projection-and-recess outer peripheral surface 121). Thus, in the
cross section perpendicular to the longitudinal axis C, the shape
surrounded by the projection-and-recess inner peripheral surface
123 of the probe holder 117 is point-symmetric with respect to the
longitudinal axis C. Specifically, the projection-and-recess inner
peripheral surface 123 of the probe holder 117 is formed point
symmetric with respect to the longitudinal axis C.
[0166] In this reference example, the projection-and-recess outer
peripheral surface 121 and projection-and-recess inner peripheral
surface 123 are point-symmetric with respect to the longitudinal
axis C. Thus, by attaching the holding forming members 122A and
122B to the probe stopper member 116, the projection-and-recess
inner peripheral surface 123 is engaged with the
projection-and-recess outer peripheral surface 121, regardless of
the angular position around the longitudinal axis C of the engaging
inner peripheral surface 119 (probe stopper member 116).
Specifically, the probe holder 117 is fixed to the probe stopper
member 116, without adjusting the angular position around the
longitudinal axis C of the projection-and-recess inner peripheral
surface 123 relative to the projection-and-recess outer peripheral
surface 121.
[0167] Because of the above-described configuration, when the probe
41 is attached to the probe holder 117 (sheath 40), the engaging
inner peripheral surface 119 of the probe stopper member 116 is
engaged with the engaging outer peripheral surface 118 of the
flange portion 115, in the state in which the treatment section 42
is disposed at a predetermined angular position around the
longitudinal axis C. At this time, although the angular positions
around the longitudinal axis C of the engaging outer peripheral
surface 118 and engaging inner peripheral surface 119 vary from
product to product, the projection-and-recess inner peripheral
surface 123 is engaged with the projection-and-recess outer
peripheral surface 121, regardless of the angular position around
the longitudinal axis C of the engaging inner peripheral surface
119 (probe stopper member 116). Thus, even when the angular
positions around the longitudinal axis C of the engaging outer
peripheral surface 118 and engaging inner peripheral surface 119
vary from product to product, the probe holder 117 can easily be
fixed to the probe stopper member 116.
[0168] Additionally, in this reference example, there is no need to
process the probe stopper member 116 in accordance with the angular
position about the longitudinal axis C of the probe stopper member
116 (flange position 115), in the state in which the probe stopper
member 116 is fixed to the probe 41. For example, in the
configuration in which the probe holder (117) is fixed to the probe
stopper member (116) by a fixing screw, it is necessary to form a
screw hole in the probe stopper member (116) in accordance with the
angular position around the longitudinal axis C of the probe
stopper member (116), in the state in which the probe stopper
member (116) is fixed to the probe (41). However, in this reference
example, there is no need to form this screw hole. Accordingly, the
probe 41 can easily be attached (fixed) to the probe holder 117
(sheath 40) in the state in which the treatment section 42 is
disposed at a predetermined angular position around the
longitudinal axis C.
[0169] Additionally, the projection-and-recess outer peripheral
surface 121 of the probe stopper member 116 and the
projection-and-recess inner peripheral surface 123 of the probe
holder 117 are engaged over the entire circumference around the
longitudinal axis C. Thus, the probe 41 can firmly be fixed to the
probe holder 117. Therefore, the strength of the probe 41 and probe
holder 117 can be secured.
[0170] Additional advantages and modifications will readily occur
to those skilled in the art. Therefore, the invention in its
broader aspects is not limited to the specific details and
representative embodiments shown and described herein. Accordingly,
various modifications may be made without departing from the spirit
or scope of the general inventive concept as defined by the
appended claims and their equivalents.
* * * * *